Provider Demographics
NPI:1205476769
Name:VILLAGE COUNSELING & WELLNESS
Entity type:Organization
Organization Name:VILLAGE COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MACHANTA
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEWSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:469-808-9730
Mailing Address - Street 1:PO BOX 1763
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-1566
Mailing Address - Country:US
Mailing Address - Phone:469-808-9730
Mailing Address - Fax:469-275-9246
Practice Address - Street 1:700 W MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:OVILLA
Practice Address - State:TX
Practice Address - Zip Code:75154-1629
Practice Address - Country:US
Practice Address - Phone:469-808-9730
Practice Address - Fax:469-275-9246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty