Provider Demographics
NPI:1629775077
Name:MIDDLE WAY WELLNESS LLC
Entity Type:Organization
Organization Name:MIDDLE WAY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:810-545-8552
Mailing Address - Street 1:515 E MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-2579
Mailing Address - Country:US
Mailing Address - Phone:586-216-8765
Mailing Address - Fax:
Practice Address - Street 1:429 LIVERNOIS ST # 214
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2385
Practice Address - Country:US
Practice Address - Phone:810-545-8552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty