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General NPI Number Information
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NPI Number | 1295232023
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Entity Type | Organization
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Legal Business Name | WELLVIEW COUNSELING LLC
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 1004 BOMBAY LN
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City | ROSWELL
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State | GA
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Zip | 30076-5820
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Country | US
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Telephone | 678-763-4464
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Fax |
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Provider Business Mailing Address
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Address Line | 807 MOSS CREEK PLANTATION
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City | JOHNS CREEK
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State | GA
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Zip | 30097-5959
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Country | US
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Telephone | 678-763-4464
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY BOBO
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Credential | LCSW
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Telephone | 678-763-4464
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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 | CSW004448
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License Number State | GA
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