Provider Demographics
NPI:1245051986
Name:BE WELL THERAPY & CONSULTATION
Entity type:Organization
Organization Name:BE WELL THERAPY & CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING REP
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFOLLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-883-0908
Mailing Address - Street 1:2550 MIDDLE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3286
Mailing Address - Country:US
Mailing Address - Phone:563-503-6756
Mailing Address - Fax:
Practice Address - Street 1:2550 MIDDLE RD STE 205
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3286
Practice Address - Country:US
Practice Address - Phone:563-503-6756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty