Provider Demographics
NPI:1023740503
Name:ESSENTIAL MENTAL WELLNESS
Entity type:Organization
Organization Name:ESSENTIAL MENTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DABREO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:917-667-2201
Mailing Address - Street 1:325 N SAINT PAUL ST STE 3100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-3923
Mailing Address - Country:US
Mailing Address - Phone:917-667-2201
Mailing Address - Fax:
Practice Address - Street 1:325 N SAINT PAUL ST STE 3100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-3923
Practice Address - Country:US
Practice Address - Phone:917-667-2201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty