Provider Demographics
NPI:1013749050
Name:ANCHOR UP WELLNESS
Entity type:Organization
Organization Name:ANCHOR UP WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LEWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:629-777-6007
Mailing Address - Street 1:7417 BIG BND
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48383-4018
Mailing Address - Country:US
Mailing Address - Phone:629-777-6007
Mailing Address - Fax:615-679-3900
Practice Address - Street 1:7417 BIG BND
Practice Address - Street 2:
Practice Address - City:WHITE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48383-4018
Practice Address - Country:US
Practice Address - Phone:629-777-6007
Practice Address - Fax:615-679-3900
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANCHOR UP WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-19
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty