Provider Demographics
NPI:1881179273
Name:BE WELL BI STATE COUNSELING
Entity Type:Organization
Organization Name:BE WELL BI STATE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BORDWINE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:302-846-7200
Mailing Address - Street 1:36729 BI STATE BLVD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:DE
Mailing Address - Zip Code:19940-3427
Mailing Address - Country:US
Mailing Address - Phone:302-846-7200
Mailing Address - Fax:302-846-7210
Practice Address - Street 1:500 N BI STATE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:DE
Practice Address - Zip Code:19940-1104
Practice Address - Country:US
Practice Address - Phone:302-846-7200
Practice Address - Fax:302-846-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty