Provider Demographics
NPI:1730960782
Name:EVERWELL COUNSELING LLC
Entity type:Organization
Organization Name:EVERWELL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-217-7313
Mailing Address - Street 1:37805 WOODRIDGE DR APT 105
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-5775
Mailing Address - Country:US
Mailing Address - Phone:734-217-7313
Mailing Address - Fax:
Practice Address - Street 1:11126 WAYNE RD STE 5
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-1473
Practice Address - Country:US
Practice Address - Phone:734-217-7313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty