Provider Demographics
NPI:1326875428
Name:WELLSONG COUNSELING LLC
Entity type:Organization
Organization Name:WELLSONG COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMEL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-470-6511
Mailing Address - Street 1:PO BOX 17013
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-0013
Mailing Address - Country:US
Mailing Address - Phone:612-470-6511
Mailing Address - Fax:
Practice Address - Street 1:4749 CHICAGO AVE STE 1C
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-4181
Practice Address - Country:US
Practice Address - Phone:612-470-6511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health