Provider Demographics
NPI:1194402495
Name:GOOD GRIEF COUNSELING
Entity type:Organization
Organization Name:GOOD GRIEF COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESNESKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:346-204-8713
Mailing Address - Street 1:540 N SUPER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011-1042
Mailing Address - Country:US
Mailing Address - Phone:346-204-8713
Mailing Address - Fax:
Practice Address - Street 1:540 N SUPER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-1042
Practice Address - Country:US
Practice Address - Phone:346-204-8713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty