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General NPI Number Information
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NPI Number | 1568101004
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Entity Type | Organization
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Legal Business Name | THERAPY AT THE WELLS, LLC
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 1530 GREENVIEW DR SW STE 117
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City | ROCHESTER
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State | MN
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Zip | 55902-1080
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Country | US
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Telephone | 507-261-4049
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Fax | 507-936-3088
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Provider Business Mailing Address
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Address Line | 1530 GREENVIEW DR SW STE 117
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City | ROCHESTER
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State | MN
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Zip | 55902-1080
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Country | US
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Telephone | 507-261-4049
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Fax | 507-936-3088
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ADAM LEE
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Credential | LADC, LMFT
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Telephone | 507-261-4049
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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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