| Essential Wellness Counseling Pllc | |
|
4350 Main St Ste 213 Harrisburg NC 28075-7448 | |
| (980) 236-1704 | |
| (980) 206-0709 |
| Full Name | Essential Wellness Counseling Pllc |
|---|---|
| Speciality | Counselor |
| Location | 4350 Main St Ste 213, Harrisburg, North Carolina |
| Authorized Official Name and Position | Tyeekia Blue (PSYCHOTHERAPIST) |
| Authorized Official Contact | 9802361704 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essential Wellness Counseling Pllc 4350 Main St Ste 213 Harrisburg NC 28075-7448 Ph: (980) 236-1704 | Essential Wellness Counseling Pllc 4350 Main St Ste 213 Harrisburg NC 28075-7448 Ph: (980) 236-1704 |
| NPI Number | 1740805019 |
|---|---|
| Provider Enumeration Date | 06/12/2020 |
| Last Update Date | 06/12/2020 |
| Certification Date | 06/12/2020 |
| Medicare PECOS PAC ID | 2466847231 |
|---|---|
| Medicare Enrollment ID | O20220314000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740805019 | NPI | - | NPPES |
| 1083153563 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tyeekia C Blue |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083153563 PECOS PAC ID: 3577892934 Enrollment ID: I20190910002105 |
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