Provider Demographics
NPI:1508738733
Name:BEWHOLE MOVEMENT
Entity type:Organization
Organization Name:BEWHOLE MOVEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED LIFE COACH
Authorized Official - Phone:919-702-3006
Mailing Address - Street 1:1209 MOUNTAIN ROAD PL NE STE 102
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7845
Mailing Address - Country:US
Mailing Address - Phone:888-433-8519
Mailing Address - Fax:
Practice Address - Street 1:1209 MOUNTAIN ROAD PL NE STE 102
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7845
Practice Address - Country:US
Practice Address - Phone:888-433-8519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health