Provider Demographics
NPI:1750252029
Name:RESTORATION AND WELLNESS COUNSELING CENTER LL
Entity type:Organization
Organization Name:RESTORATION AND WELLNESS COUNSELING CENTER LL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHATIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-559-5641
Mailing Address - Street 1:3288 GRAMERCY PL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-0580
Mailing Address - Country:US
Mailing Address - Phone:850-559-5641
Mailing Address - Fax:
Practice Address - Street 1:1112 THOMASVILLE RD STE 5
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6534
Practice Address - Country:US
Practice Address - Phone:850-591-0738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty