Provider Demographics
NPI:1720655392
Name:WELL AND WONDERS COUNSELING, LLC
Entity type:Organization
Organization Name:WELL AND WONDERS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:POLACEK
Authorized Official - Suffix:
Authorized Official - Credentials:MSED, LIMHP, CPC
Authorized Official - Phone:402-302-1126
Mailing Address - Street 1:301 S 70TH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2472
Mailing Address - Country:US
Mailing Address - Phone:402-302-1126
Mailing Address - Fax:
Practice Address - Street 1:301 S 70TH ST STE 350
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2472
Practice Address - Country:US
Practice Address - Phone:402-302-1126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty