Provider Demographics
NPI:1689114621
Name:BE WELL, LLC
Entity Type:Organization
Organization Name:BE WELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLEESE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:832-886-8111
Mailing Address - Street 1:741 HUNTLY DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-6650
Mailing Address - Country:US
Mailing Address - Phone:832-886-8111
Mailing Address - Fax:
Practice Address - Street 1:741 HUNTLY DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-6650
Practice Address - Country:US
Practice Address - Phone:832-886-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005219251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health