Provider Demographics
NPI:1396586046
Name:KAPWA WELLNESS LLC
Entity type:Organization
Organization Name:KAPWA WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:MAGALINDAN
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:434-414-4130
Mailing Address - Street 1:3303 JOHN TREE HILL RD
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-4521
Mailing Address - Country:US
Mailing Address - Phone:434-414-4130
Mailing Address - Fax:
Practice Address - Street 1:4920 MILLRIDGE PKWY E
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4857
Practice Address - Country:US
Practice Address - Phone:804-372-7468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty