Provider Demographics
NPI:1891842795
Name:CENTER FOR COGNITIVE & EMOTIONAL WELL-BEING, LLC
Entity Type:Organization
Organization Name:CENTER FOR COGNITIVE & EMOTIONAL WELL-BEING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:302-477-9596
Mailing Address - Street 1:1415 FOULK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2748
Mailing Address - Country:US
Mailing Address - Phone:302-477-9596
Mailing Address - Fax:610-989-3638
Practice Address - Street 1:1415 FOULK RD STE 100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2748
Practice Address - Country:US
Practice Address - Phone:302-477-9596
Practice Address - Fax:610-989-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty