| Be Whole Counseling And Wellness Services, Pllc | |
|
9635 Southern Pine Blvd Ste 124 Charlotte NC 28273 | |
| (704) 733-7475 | |
| Not Available |
| Full Name | Be Whole Counseling And Wellness Services, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 9635 Southern Pine Blvd Ste 124, Charlotte, North Carolina |
| Authorized Official Name and Position | Isis Reddick-umoja (CLINICAL DIRECTOR/THERAPIST) |
| Authorized Official Contact | 7047337475 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Be Whole Counseling And Wellness Services, Pllc 10506 Grobie Way Apt 207 Charlotte NC 28216-0251 Ph: (704) 733-7475 | Be Whole Counseling And Wellness Services, Pllc 9635 Southern Pine Blvd Ste 124 Charlotte NC 28273 Ph: (704) 733-7475 |
| NPI Number | 1770851388 |
|---|---|
| Provider Enumeration Date | 12/09/2011 |
| Last Update Date | 03/12/2019 |
| Medicare PECOS PAC ID | 6103250725 |
|---|---|
| Medicare Enrollment ID | O20200107001162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770851388 | NPI | - | NPPES |
| 6103236 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5341 (North Carolina) | Primary |
| Provider Name | Isis Reddick-umoja |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598875247 PECOS PAC ID: 0749614378 Enrollment ID: I20240423002387 |
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