| Awakening Wellness Professional Corporation | |
|
1508 Military Cutoff Rd Ste 205 Wilmington NC 28403-5730 | |
| (910) 470-2387 | |
| Not Available |
| Full Name | Awakening Wellness Professional Corporation |
|---|---|
| Speciality | Social Worker |
| Location | 1508 Military Cutoff Rd Ste 205, Wilmington, North Carolina |
| Authorized Official Name and Position | Marion Easton Alburger Gittings (OWNER/PRESIDENT) |
| Authorized Official Contact | 9104702387 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Awakening Wellness Professional Corporation 313 Apollo Dr Wilmington NC 28405-3903 Ph: (910) 470-2387 | Awakening Wellness Professional Corporation 1508 Military Cutoff Rd Ste 205 Wilmington NC 28403-5730 Ph: (910) 470-2387 |
| NPI Number | 1659648954 |
|---|---|
| Provider Enumeration Date | 11/30/2011 |
| Last Update Date | 03/24/2022 |
| Certification Date | 03/24/2022 |
| Medicare PECOS PAC ID | 2264689405 |
|---|---|
| Medicare Enrollment ID | O20120823000511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659648954 | NPI | - | NPPES |
| 2853434 | Other | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C005205 (North Carolina) | Primary |
| Provider Name | Marion E Gittings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467519132 PECOS PAC ID: 1759428501 Enrollment ID: I20091027000587 |
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