Provider Demographics
NPI:1568101004
Name:THERAPY AT THE WELLS, LLC
Entity Type:Organization
Organization Name:THERAPY AT THE WELLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, LMFT
Authorized Official - Phone:507-261-4049
Mailing Address - Street 1:1530 GREENVIEW DR SW STE 117
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-1080
Mailing Address - Country:US
Mailing Address - Phone:507-261-4049
Mailing Address - Fax:507-936-3088
Practice Address - Street 1:1530 GREENVIEW DR SW STE 117
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-1080
Practice Address - Country:US
Practice Address - Phone:507-261-4049
Practice Address - Fax:507-936-3088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty