Provider Demographics
NPI:1831713734
Name:MENTAL HEALTH AND WELLNESS COUNSELING LLC
Entity type:Organization
Organization Name:MENTAL HEALTH AND WELLNESS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:VERONICA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC
Authorized Official - Phone:239-989-8410
Mailing Address - Street 1:2740 OAK RIDGE CT STE 301
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9371
Mailing Address - Country:US
Mailing Address - Phone:239-989-8410
Mailing Address - Fax:239-931-4444
Practice Address - Street 1:2740 OAK RIDGE CT STE 301
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9371
Practice Address - Country:US
Practice Address - Phone:239-989-8410
Practice Address - Fax:239-931-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty