Provider Demographics
NPI:1336842111
Name:COMMONWEALTH COUNSELING & WELLNESS
Entity Type:Organization
Organization Name:COMMONWEALTH COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-870-7765
Mailing Address - Street 1:283 CONSTITUTION DR STE 600
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6760
Mailing Address - Country:US
Mailing Address - Phone:757-870-7765
Mailing Address - Fax:
Practice Address - Street 1:283 CONSTITUTION DR STE 600
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6760
Practice Address - Country:US
Practice Address - Phone:757-870-7765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty