Provider Demographics
NPI:1568284354
Name:SOMOS WELLNESS COUNSELING
Entity type:Organization
Organization Name:SOMOS WELLNESS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:P
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-877-3219
Mailing Address - Street 1:2415 BOYLE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-2325
Mailing Address - Country:US
Mailing Address - Phone:804-833-0192
Mailing Address - Fax:
Practice Address - Street 1:5809 LAKESIDE AVE STE G1C
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-5746
Practice Address - Country:US
Practice Address - Phone:804-877-3219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty