Behavioral Wellness Group

Key facts

NPI

1073387486

Entity type

Organization (NPI type 2)

Primary specialty

Professional Counselor 101YP2500X

Legal business name

BEHAVIORAL WELLNESS GROUP

Practice address

1819 Main St # a
Blakely, PA 18447-1351

Phone

(570) 780-6558

NPI assigned

Nov 7, 2023

Organization subpart

No

Authorized official

Name

Phillip John Prall Jr., MS, CRC, LPC NPI 1285398214

Title

Licensed Professional Counselor

Phone

(570) 780-6558

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip Prall Community/Behavioral Health Agency · South Abington Township, PA · NPI 1285398214
  NPD Authorized official

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 7, 2023.

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1073387486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 MAIN ST # A",
            "city": "BLAKELY",
            "state": "PA",
            "postal_code": "184471351",
            "telephone_number": "570-780-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 MAIN ST # A",
            "city": "BLAKELY",
            "state": "PA",
            "postal_code": "184471351",
            "telephone_number": "570-780-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "PRALL",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "570-780-6558",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MS, CRC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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