MEDICARE: BE WELL COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1639045446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE WELL COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	36 RICE SPRING LN
Second Line	:
City	:	WAYLAND
State	:	MA
Zip	:	01778-3516
Country	:	US
Telephone Number	:	781-771-0687
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 RICE SPRING LN
Second Line	:
City	:	WAYLAND
State	:	MA
Zip	:	01778-3516
Country	:	US
Telephone Number	:	781-771-0687
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NANCY E FUNKHOUSER
Credential	:	LISCW
Telephone Number	:	781-771-0687

Provider Enumeration Date	:	10/17/2025
Last Update Date	:	10/17/2025

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