Provider Demographics
NPI:1710515036
Name:WELL PLAY FAMILY COUNSELING, INC.
Entity Type:Organization
Organization Name:WELL PLAY FAMILY COUNSELING, INC.
Other - Org Name:WELL-PLAY COUNSELING & WELLBEING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:323-573-9270
Mailing Address - Street 1:404 N BROADWAY APT 1
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2805
Mailing Address - Country:US
Mailing Address - Phone:323-573-9270
Mailing Address - Fax:424-206-1094
Practice Address - Street 1:2001 S BARRINGTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5363
Practice Address - Country:US
Practice Address - Phone:323-573-9270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELL PLAY FAMILY COUNSELING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-31
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)