Provider Demographics
NPI:1912658402
Name:THE WELL COUNSELING
Entity type:Organization
Organization Name:THE WELL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:803-406-1394
Mailing Address - Street 1:3133 DAUFASKIE RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1895
Mailing Address - Country:US
Mailing Address - Phone:803-774-4355
Mailing Address - Fax:
Practice Address - Street 1:259A BROAD ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4146
Practice Address - Country:US
Practice Address - Phone:803-774-4355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty