MEDICARE: BE WELL COUNSELING, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1447813050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE WELL COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	2111 E BASELINE RD STE C3
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-1521
Country	:	US
Telephone Number	:	480-233-7529
Fax Number	:

Provider Business Practice Location Address
First Line	:	2111 E BASELINE RD STE C3
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-1521
Country	:	US
Telephone Number	:	480-233-7529
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OWNER
Name	:	BONNIE BEEBE
Credential	:	LPC
Telephone Number	:	480-233-7529

Provider Enumeration Date	:	04/18/2019
Last Update Date	:	04/18/2019

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