Provider Demographics
NPI:1386360691
Name:WELL ROUNDED LLC
Entity type:Organization
Organization Name:WELL ROUNDED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:CARSON
Authorized Official - Last Name:WILMOT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:903-271-0657
Mailing Address - Street 1:828 5TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2137
Mailing Address - Country:US
Mailing Address - Phone:903-271-0657
Mailing Address - Fax:
Practice Address - Street 1:828 5TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2137
Practice Address - Country:US
Practice Address - Phone:903-271-0657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty