Healthcare Provider Details

I. General information

NPI: 1437442647
Provider Name (Legal Business Name): WELLNESS ARTS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 05/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 CEDAR ST STUDIO 313
AMESBURY MA
01913-1831
US

IV. Provider business mailing address

14 CEDAR ST. STUDIO 313
AMESBURY MA
01913-1831
US

V. Phone/Fax

Practice location:
  • Phone: 978-207-7971
  • Fax:
Mailing address:
  • Phone: 978-207-7971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7652
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number7652
License Number StateMA

VIII. Authorized Official

Name: MS. COREY BROWN RAICHE
Title or Position: OWNER/OPERATOR
Credential: L.M.H.C.
Phone: 978-207-7971