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Individual
KEVIN W WELLS
Active
Individual
KEVIN W WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CACI
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12053115
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12053115
MA, CACI
SC
05
—
190166
—
SC
Enumeration date
08/21/2007
Last updated
01/31/2013
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