| Good Stress Company Pllc | |
|
10150 Mallard Creek Rd Ste 104 Charlotte NC 28262-4567 | |
| (980) 242-7090 | |
| (980) 556-7219 |
| Full Name | Good Stress Company Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 10150 Mallard Creek Rd Ste 104, Charlotte, North Carolina |
| Authorized Official Name and Position | Rwenshaun Miller (CEO) |
| Authorized Official Contact | 9196249954 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Stress Company Pllc 10150 Mallard Creek Rd Ste 104 Charlotte NC 28262-4567 Ph: (980) 242-7090 | Good Stress Company Pllc 10150 Mallard Creek Rd Ste 104 Charlotte NC 28262-4567 Ph: (980) 242-7090 |
| NPI Number | 1679079099 |
|---|---|
| Provider Enumeration Date | 04/04/2018 |
| Last Update Date | 09/09/2021 |
| Certification Date | 04/01/2021 |
| Medicare PECOS PAC ID | 6305170085 |
|---|---|
| Medicare Enrollment ID | O20190701000087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679079099 | NPI | - | NPPES |
| Provider Name | Latasha R Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588834030 PECOS PAC ID: 9436225562 Enrollment ID: I20080913000110 |
| Provider Name | Donnetta Lafaye Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932514601 PECOS PAC ID: 5496185456 Enrollment ID: I20200415003103 |
| Provider Name | Jennifer Mckethan Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225287295 PECOS PAC ID: 4880024470 Enrollment ID: I20200422002547 |
| Provider Name | Phylicia Jasmin Currence |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043828197 PECOS PAC ID: 6800286766 Enrollment ID: I20211208000982 |
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