Provider Demographics
NPI:1710552161
Name:EQUILIBRIUM COUNSELING AND WELLNESS LLC
Entity Type:Organization
Organization Name:EQUILIBRIUM COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:DOLL
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:316-530-1174
Mailing Address - Street 1:450 N 159TH ST E
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-7704
Mailing Address - Country:US
Mailing Address - Phone:316-530-1174
Mailing Address - Fax:316-633-4174
Practice Address - Street 1:450 N 159TH ST E
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-7704
Practice Address - Country:US
Practice Address - Phone:316-530-1174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty