Provider Demographics
NPI:1033093505
Name:WELL-GROUNDED COUNSELING LLC
Entity type:Organization
Organization Name:WELL-GROUNDED COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAXON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NBCC
Authorized Official - Phone:267-225-3069
Mailing Address - Street 1:502 W 7TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1333
Mailing Address - Country:US
Mailing Address - Phone:267-225-3069
Mailing Address - Fax:
Practice Address - Street 1:582 LIVEZEY ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2451
Practice Address - Country:US
Practice Address - Phone:608-957-5714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty