| Reboot Behavioral Health Pllc | |
|
3011 Town Center Dr Ste 130 Unit #122 Fayetteville NC 28306 | |
| (910) 727-4590 | |
| (910) 407-9529 |
| Full Name | Reboot Behavioral Health Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 3011 Town Center Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Erica T Powell (CEO) |
| Authorized Official Contact | 9103058893 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reboot Behavioral Health Pllc 5917 Fuchsia Ct Stedman NC 28391-3401 Ph: (910) 305-8893 | Reboot Behavioral Health Pllc 3011 Town Center Dr Ste 130 Unit #122 Fayetteville NC 28306 Ph: (910) 727-4590 |
| NPI Number | 1932832557 |
|---|---|
| Provider Enumeration Date | 07/01/2022 |
| Last Update Date | 07/01/2022 |
| Certification Date | 07/01/2022 |
| Medicare PECOS PAC ID | 8224488416 |
|---|---|
| Medicare Enrollment ID | O20231229002902 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932832557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Erica Powell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235708363 PECOS PAC ID: 5395143655 Enrollment ID: I20231229002917 |
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