| Mental Wellness Clinical Counseling And Services | |
|
127 Goldsboro St S Wilson NC 27893-4903 | |
| (252) 469-7007 | |
| Not Available |
| Full Name | Mental Wellness Clinical Counseling And Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 127 Goldsboro St S, Wilson, North Carolina |
| Authorized Official Name and Position | Shirria Mccullough (OWNER) |
| Authorized Official Contact | 2524697007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Wellness Clinical Counseling And Services 5820 Farmwood Loop Wilson NC 27896-8005 Ph: (252) 469-7007 | Mental Wellness Clinical Counseling And Services 127 Goldsboro St S Wilson NC 27893-4903 Ph: (252) 469-7007 |
| NPI Number | 1265024863 |
|---|---|
| Provider Enumeration Date | 02/05/2021 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Medicare PECOS PAC ID | 5193122802 |
|---|---|
| Medicare Enrollment ID | O20210923000336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265024863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Shirria D. Mccullough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811243959 PECOS PAC ID: 9830497999 Enrollment ID: I20160406001416 |
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