Provider Demographics
NPI:1871211995
Name:WELL REASONED THERAPY
Entity type:Organization
Organization Name:WELL REASONED THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REID
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-325-9144
Mailing Address - Street 1:2015 AYRSLEY TOWN BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4068
Mailing Address - Country:US
Mailing Address - Phone:561-325-9144
Mailing Address - Fax:
Practice Address - Street 1:8423 VIA LEONESSA
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2222
Practice Address - Country:US
Practice Address - Phone:561-325-9144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH20112OtherLICENSED MENTAL HEALTH COUNSELOR