Provider Demographics
NPI:1396328035
Name:ROSEWATER COUNSELING & WELLNESS PLLC
Entity type:Organization
Organization Name:ROSEWATER COUNSELING & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ELMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:903-372-3958
Mailing Address - Street 1:825 WATTERS CREEK BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3770
Mailing Address - Country:US
Mailing Address - Phone:469-560-5427
Mailing Address - Fax:
Practice Address - Street 1:825 WATTERS CREEK BLVD STE 250
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3770
Practice Address - Country:US
Practice Address - Phone:469-560-5427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty