Provider Demographics
NPI:1679947659
Name:FORWARD WELLNESS COUNSELING AND CONSULTING SERVICES LLC
Entity type:Organization
Organization Name:FORWARD WELLNESS COUNSELING AND CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HNATKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-605-4211
Mailing Address - Street 1:3464 CAMPUS ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-2204
Mailing Address - Country:US
Mailing Address - Phone:412-605-4211
Mailing Address - Fax:
Practice Address - Street 1:239 4TH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-1706
Practice Address - Country:US
Practice Address - Phone:412-605-4211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare