Provider Demographics
NPI:1669637609
Name:EMOTIONAL WELLNESS COUNSELING INC
Entity Type:Organization
Organization Name:EMOTIONAL WELLNESS COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:QUINTAL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LICSW
Authorized Official - Phone:508-995-1400
Mailing Address - Street 1:75 POTTER ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748-1818
Mailing Address - Country:US
Mailing Address - Phone:508-997-5132
Mailing Address - Fax:508-996-9360
Practice Address - Street 1:3267 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-3918
Practice Address - Country:US
Practice Address - Phone:508-995-1400
Practice Address - Fax:508-995-5659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113643251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA11718217OtherCAQH PROVIDER ID