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General NPI Number Information
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NPI Number | 1932928413
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Entity Type | Organization
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Legal Business Name | AUTHENTIC WELLNESS COUNSELING CENTER
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 1031 ANDREWS HWY STE 206
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City | MIDLAND
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State | TX
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Zip | 79701-3805
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Country | US
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Telephone | 432-230-6147
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 BRIGHTON PL
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City | MIDLAND
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State | TX
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Zip | 79705-2818
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Country | US
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Telephone | 432-230-6147
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. HEATHER MASON
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Credential | LPC-S
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Telephone | 432-230-6147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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