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General NPI Number Information
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NPI Number | 1235887233
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Entity Type | Organization
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Legal Business Name | WELLYOU THERAPY
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 818 N MOUNTAIN AVE STE 203A
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City | UPLAND
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State | CA
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Zip | 91786-4165
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Country | US
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Telephone | 631-213-7940
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 NORTHSIDE DRIVE SUITE A7, UNIT #5965
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City | ATLANTA
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State | GA
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Zip | 30318
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VICTOR FURTICK
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Credential |
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Telephone | 631-213-7940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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