Provider Demographics
NPI:1851659080
Name:DAY ONE WELLNESS
Entity Type:Organization
Organization Name:DAY ONE WELLNESS
Other - Org Name:JOHANNA E. BECKER, LPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-620-2257
Mailing Address - Street 1:1911 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1905
Mailing Address - Country:US
Mailing Address - Phone:757-620-2257
Mailing Address - Fax:757-663-7895
Practice Address - Street 1:1911 COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1905
Practice Address - Country:US
Practice Address - Phone:757-620-2257
Practice Address - Fax:757-663-7895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty