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General NPI Number Information
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NPI Number | 1710754205
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Entity Type | Organization
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Legal Business Name | ENDEAVORING WELLNESS LLC
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 2313 E VENANGO ST STE 4B
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City | PHILADELPHIA
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State | PA
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Zip | 19134-4621
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Country | US
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Telephone | 215-469-1356
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Fax |
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Provider Business Mailing Address
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Address Line | 2313 E VENANGO ST., STE 4B #1010
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City | PHILADELPHIA
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State | PA
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Zip | 19134-4621
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Country | US
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Telephone | 215-469-1356
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OKICHIE DAVIS
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Credential | LPC, LCPC, ACS, NCC
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Telephone | 215-469-1356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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