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Organization
PHOENIX COUNSELING AND WELLNESS, LLC
Active
Organization
PHOENIX COUNSELING AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE NASHELLE LOCKETT MSSA, LSW (CLINICAL THERAPIST/OWNER)
(440) 571-5009
Entity
Organization
Contact information
Practice address
35104 EUCLID AVE STE 306, WILLOUGHBY, OH 44094-4566
(440) 571-5009
(440) 571-4850
Mailing address
35104 EUCLID AVE STE 306, WILLOUGHBY, OH 44094-4566
(440) 571-5009
(440) 571-4850
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497255343
—
OH
Enumeration date
08/11/2020
Last updated
10/27/2022
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