Provider Demographics
NPI:1801363304
Name:ASSOCIATES FOR WELL-BEING
Entity Type:Organization
Organization Name:ASSOCIATES FOR WELL-BEING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELESKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-792-3587
Mailing Address - Street 1:4574 SILVERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-1269
Mailing Address - Country:US
Mailing Address - Phone:215-792-3587
Mailing Address - Fax:
Practice Address - Street 1:4001 MAIN STREET, SUITE 202
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19127
Practice Address - Country:US
Practice Address - Phone:215-792-3587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty