Provider Demographics
NPI:1831067321
Name:IJS WELLNESS COLLECTIVE
Entity type:Organization
Organization Name:IJS WELLNESS COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ISABELLA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SEGOVIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHCA
Authorized Official - Phone:949-374-8766
Mailing Address - Street 1:9900 12TH AVE W APT B201
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-1158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9900 12TH AVE W APT B201
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-1158
Practice Address - Country:US
Practice Address - Phone:949-374-8766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty