Provider Demographics
NPI: | 1497555858 |
---|---|
Name: | WOLLEMI COUNSELING LLC |
Entity type: | Organization |
Organization Name: | WOLLEMI COUNSELING LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RACHEL |
Authorized Official - Middle Name: | E |
Authorized Official - Last Name: | BOWERS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LISW-S |
Authorized Official - Phone: | 440-476-1410 |
Mailing Address - Street 1: | 27540 DETROIT RD STE 105 |
Mailing Address - Street 2: | |
Mailing Address - City: | WESTLAKE |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 44145-2299 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 440-476-1410 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 27540 DETROIT RD STE 105 |
Practice Address - Street 2: | |
Practice Address - City: | WESTLAKE |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44145-2299 |
Practice Address - Country: | US |
Practice Address - Phone: | 440-476-1410 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-03-15 |
Last Update Date: | 2025-04-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 251S00000X | Agencies | Community/Behavioral Health |