Provider Demographics
NPI:1942753504
Name:COUNSELING & WELLNESS CENTER-OH LLC
Entity Type:Organization
Organization Name:COUNSELING & WELLNESS CENTER-OH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-422-7300
Mailing Address - Street 1:225 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1691
Mailing Address - Country:US
Mailing Address - Phone:304-422-7300
Mailing Address - Fax:304-428-3719
Practice Address - Street 1:225 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1691
Practice Address - Country:US
Practice Address - Phone:304-422-7300
Practice Address - Fax:304-428-3719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty