=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114897394
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUMAN & CO. WELLNESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2025
-----------------------------------------------------
Last Update Date | 11/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 346 OAKHURST DR
-----------------------------------------------------
City | MURPHY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75094-4478
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-777-9947
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 346 OAKHURST DR
-----------------------------------------------------
City | MURPHY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75094-4478
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LPC - ASSOCIATE
-----------------------------------------------------
Name | MALAIYA ILENE LIWAG
-----------------------------------------------------
Credential | MA, LPC-ASSOCIATE
-----------------------------------------------------
Telephone | 469-777-9947
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------