| Heartwood Performance, Pllc | |
|
5960 Fairview Rd Ste 400 Charlotte NC 28210-3119 | |
| (704) 476-5575 | |
| Not Available |
| Full Name | Heartwood Performance, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5960 Fairview Rd Ste 400, Charlotte, North Carolina |
| Authorized Official Name and Position | Benjamin Foodman (OWNER) |
| Authorized Official Contact | 7044181333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartwood Performance, Pllc 15720 Brixham Hill Ave Charlotte NC 28277-4651 Ph: (704) 476-5575 | Heartwood Performance, Pllc 5960 Fairview Rd Ste 400 Charlotte NC 28210-3119 Ph: (704) 476-5575 |
| NPI Number | 1598250300 |
|---|---|
| Provider Enumeration Date | 06/25/2018 |
| Last Update Date | 09/13/2021 |
| Certification Date | 09/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598250300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C010390 (North Carolina) | Primary |
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