Provider Demographics
NPI:1972198562
Name:WELL WITHIN COUNSELING, LLC
Entity Type:Organization
Organization Name:WELL WITHIN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:MARTYN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-633-9485
Mailing Address - Street 1:150 N LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-1143
Mailing Address - Country:US
Mailing Address - Phone:301-633-9485
Mailing Address - Fax:443-652-6300
Practice Address - Street 1:150 N LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-1143
Practice Address - Country:US
Practice Address - Phone:301-633-9485
Practice Address - Fax:443-652-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty