Provider Demographics
NPI:1386329043
Name:INTEGRATIVE COUNSELING AND WELLNESS LLC
Entity type:Organization
Organization Name:INTEGRATIVE COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:440-523-9264
Mailing Address - Street 1:6418 FAWN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-5817
Mailing Address - Country:US
Mailing Address - Phone:440-523-9264
Mailing Address - Fax:
Practice Address - Street 1:6418 FAWN LN
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-5817
Practice Address - Country:US
Practice Address - Phone:440-523-9264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)