Provider Demographics
NPI:1710756267
Name:MOUNTAIN VIEW WELLNESS AND CONSULTING LLC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW WELLNESS AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:VASSEUR
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:802-279-8039
Mailing Address - Street 1:4916 COLUMBIA RD APT 4
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2167
Mailing Address - Country:US
Mailing Address - Phone:802-279-8039
Mailing Address - Fax:
Practice Address - Street 1:4916 COLUMBIA RD APT 4
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2167
Practice Address - Country:US
Practice Address - Phone:802-279-8039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)