Provider Demographics
NPI:1174949242
Name:THE WELL COUNSELING
Entity type:Organization
Organization Name:THE WELL COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-310-7086
Mailing Address - Street 1:1181 N MILFORD RD
Mailing Address - Street 2:STE. 201
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1061
Mailing Address - Country:US
Mailing Address - Phone:248-310-7086
Mailing Address - Fax:
Practice Address - Street 1:1181 N MILFORD RD
Practice Address - Street 2:STE. 201
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1061
Practice Address - Country:US
Practice Address - Phone:248-310-7086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-12
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010867401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty