Provider Demographics
NPI:1477878122
Name:RHIO WELLNESS LCSW, PLLC
Entity type:Organization
Organization Name:RHIO WELLNESS LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:DEMARIUS
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-357-7446
Mailing Address - Street 1:5835 UTOPIA PKWY
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1526
Mailing Address - Country:US
Mailing Address - Phone:718-357-7446
Mailing Address - Fax:718-559-6473
Practice Address - Street 1:5835 UTOPIA PKWY
Practice Address - Street 2:SUITE 1-C
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-1526
Practice Address - Country:US
Practice Address - Phone:718-869-6993
Practice Address - Fax:718-559-6473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0767291041C0700X
NY699561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty