Provider Demographics
NPI:1932774502
Name:THERAPY & WELLNESS SERVICES LLC
Entity Type:Organization
Organization Name:THERAPY & WELLNESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR /E
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOUALLOL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LCPC
Authorized Official - Phone:630-251-2902
Mailing Address - Street 1:1809 BEACONSFIELD DR.
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543
Mailing Address - Country:US
Mailing Address - Phone:630-251-2902
Mailing Address - Fax:
Practice Address - Street 1:2824 WINDGUARD CIR
Practice Address - Street 2:STE 101
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544
Practice Address - Country:US
Practice Address - Phone:813-665-0210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty