| Providential Care: Center For Mental Wellness, Pllc | |
|
3340b Ellsworth Dr Greenville NC 27834-4944 | |
| (252) 917-8182 | |
| Not Available |
| Full Name | Providential Care: Center For Mental Wellness, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3340b Ellsworth Dr, Greenville, North Carolina |
| Authorized Official Name and Position | Richelle Lafaye Smallwood (OWNER, CLINICIAN) |
| Authorized Official Contact | 2523158081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providential Care: Center For Mental Wellness, Pllc Po Box 30882 Greenville NC 27833-0882 Ph: (252) 917-8182 | Providential Care: Center For Mental Wellness, Pllc 3340b Ellsworth Dr Greenville NC 27834-4944 Ph: (252) 917-8182 |
| NPI Number | 1750034294 |
|---|---|
| Provider Enumeration Date | 02/03/2022 |
| Last Update Date | 02/03/2022 |
| Certification Date | 02/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750034294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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