Provider Demographics
NPI:1710553060
Name:BE WELL PROFESSIONAL SERVICES LLC
Entity Type:Organization
Organization Name:BE WELL PROFESSIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, LCSW
Authorized Official - Prefix:
Authorized Official - First Name:ADA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:SALGADO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:310-387-3761
Mailing Address - Street 1:9663 SANTA MONICA BLVD # 508
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4303
Mailing Address - Country:US
Mailing Address - Phone:310-387-3761
Mailing Address - Fax:
Practice Address - Street 1:433 N CAMDEN DRIVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-387-3761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty