Provider Demographics
NPI:1891539094
Name:I AM WELL CONSULTING, LLC
Entity type:Organization
Organization Name:I AM WELL CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:731-694-2839
Mailing Address - Street 1:6216 DEL SOL DR
Mailing Address - Street 2:
Mailing Address - City:WHITES CREEK
Mailing Address - State:TN
Mailing Address - Zip Code:37189-2902
Mailing Address - Country:US
Mailing Address - Phone:731-694-2839
Mailing Address - Fax:
Practice Address - Street 1:103 CONTINENTAL PL STE 204
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1041
Practice Address - Country:US
Practice Address - Phone:615-543-6589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty