Provider Demographics
NPI:1891396685
Name:BE WELL BEHAVIORAL HEALING LLC
Entity Type:Organization
Organization Name:BE WELL BEHAVIORAL HEALING LLC
Other - Org Name:BE WELL BEHAVIORAL HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:LOY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:859-300-6860
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:SADIEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40370-0025
Mailing Address - Country:US
Mailing Address - Phone:859-300-6860
Mailing Address - Fax:
Practice Address - Street 1:245 MAIN ST
Practice Address - Street 2:
Practice Address - City:SADIEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40370-9576
Practice Address - Country:US
Practice Address - Phone:859-300-6860
Practice Address - Fax:502-891-9793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty