Provider Demographics
NPI:1104584242
Name:BE WELL MENTAL HEALTH CENTER PLLC
Entity type:Organization
Organization Name:BE WELL MENTAL HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-NP
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:VERHAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:903-364-6357
Mailing Address - Street 1:1438 E RUSK ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-3450
Mailing Address - Country:US
Mailing Address - Phone:903-721-3250
Mailing Address - Fax:
Practice Address - Street 1:1438 E RUSK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-3450
Practice Address - Country:US
Practice Address - Phone:903-721-3250
Practice Address - Fax:903-213-9029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty