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General NPI Number Information
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NPI Number | 1538646450
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Entity Type | Organization
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Legal Business Name | BE WELL WITHIN, LLC
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 101 TIMBERLACHEN CIR STE 101
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City | LAKE MARY
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State | FL
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Zip | 32746-6124
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Country | US
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Telephone | 407-302-8622
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Fax | 407-330-5244
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Provider Business Mailing Address
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Address Line | 101 TIMBERLACHEN CIR STE 101
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City | LAKE MARY
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State | FL
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Zip | 32746-6124
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Country | US
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Telephone | 407-302-8622
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Fax | 407-330-5244
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | ERIN GRAY
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Credential | LMHC
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Telephone | 407-302-8622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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