Provider Demographics
NPI:1568003903
Name:AUTHENTIC COUNSELING AND WELLNESS, LLC
Entity type:Organization
Organization Name:AUTHENTIC COUNSELING AND WELLNESS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:423-715-3904
Mailing Address - Street 1:2990 WESTSIDE DR NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3506
Mailing Address - Country:US
Mailing Address - Phone:423-458-1870
Mailing Address - Fax:423-458-1871
Practice Address - Street 1:2990 WESTSIDE DR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3506
Practice Address - Country:US
Practice Address - Phone:423-458-1870
Practice Address - Fax:423-458-1871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-07
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty