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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