Provider Demographics
NPI:1194134098
Name:BE WELL COUNSELING SERVICES, PC
Entity type:Organization
Organization Name:BE WELL COUNSELING SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSSI
Authorized Official - Middle Name:CATANA
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:575-760-0754
Mailing Address - Street 1:044 SOUTH ROOSEVELT RD AD
Mailing Address - Street 2:
Mailing Address - City:PORTALES
Mailing Address - State:NM
Mailing Address - Zip Code:88130
Mailing Address - Country:US
Mailing Address - Phone:575-760-0754
Mailing Address - Fax:
Practice Address - Street 1:044 SOUTH ROOSEVELT RD AD
Practice Address - Street 2:
Practice Address - City:PORTALES
Practice Address - State:NM
Practice Address - Zip Code:88130
Practice Address - Country:US
Practice Address - Phone:575-760-0754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health