Provider Demographics
NPI:1639664329
Name:BE WELL COUNSELING AND LIFE COACH SERVICES,LLC
Entity type:Organization
Organization Name:BE WELL COUNSELING AND LIFE COACH SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAGNOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-895-9508
Mailing Address - Street 1:2130 ROUTE 35 STE 227
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1011
Mailing Address - Country:US
Mailing Address - Phone:732-895-9508
Mailing Address - Fax:
Practice Address - Street 1:2130 HIGHWAY 35 STE 227
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1011
Practice Address - Country:US
Practice Address - Phone:732-895-9508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057490001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty