Provider Demographics
NPI:1609455054
Name:ARENA COUNSELING AND WELLNESS LLC
Entity Type:Organization
Organization Name:ARENA COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / LMHC
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, EDS, LMHC
Authorized Official - Phone:352-329-2040
Mailing Address - Street 1:235 S MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-6585
Mailing Address - Country:US
Mailing Address - Phone:352-329-2040
Mailing Address - Fax:
Practice Address - Street 1:235 S MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6585
Practice Address - Country:US
Practice Address - Phone:352-329-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty