Provider Demographics
NPI:1932685310
Name:THE COUNSELING AND WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:THE COUNSELING AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-808-6377
Mailing Address - Street 1:3971 HOOVER RD STE 247
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2839
Mailing Address - Country:US
Mailing Address - Phone:614-638-6493
Mailing Address - Fax:614-890-5485
Practice Address - Street 1:3455 CENTERPOINT DR STE J
Practice Address - Street 2:
Practice Address - City:URBANCREST
Practice Address - State:OH
Practice Address - Zip Code:43123-1498
Practice Address - Country:US
Practice Address - Phone:614-808-6377
Practice Address - Fax:614-890-5485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0500252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty