Provider Demographics
NPI:1629768247
Name:ANDNATE COUNSELING AND WELLNESS SERVICES, A LICENSED CLINICAL SOCIAL W
Entity Type:Organization
Organization Name:ANDNATE COUNSELING AND WELLNESS SERVICES, A LICENSED CLINICAL SOCIAL W
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:CARPIO
Authorized Official - Suffix:
Authorized Official - Credentials:LISW/LCSW
Authorized Official - Phone:310-439-9049
Mailing Address - Street 1:3500 LORAIN AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3726
Mailing Address - Country:US
Mailing Address - Phone:310-439-9049
Mailing Address - Fax:
Practice Address - Street 1:3500 LORAIN AVE STE 400
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3726
Practice Address - Country:US
Practice Address - Phone:310-439-9049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty