Healthcare Provider Details

I. General information

NPI: 1962317867
Provider Name (Legal Business Name): BE WELL PSYCHIATRY AND COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7381 BEAVER GLEN CIR
HAHIRA GA
31632-2273
US

IV. Provider business mailing address

505 S CHURCH ST # 4C
HAHIRA GA
31632-1413
US

V. Phone/Fax

Practice location:
  • Phone: 229-414-8813
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AL BERRY
Title or Position: CREDENTIALING MANAGER
Credential: MANAGER
Phone: 469-915-4211