MEDICARE: BWELL INTEGRATIVE PSYCHIATRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1619868635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BWELL INTEGRATIVE PSYCHIATRY PLLC

Provider Business Mailing Address
First Line	:	224 GREEN ST
Second Line	:
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892-2000
Country	:	US
Telephone Number	:	252-776-0153
Fax Number	:	252-350-5238

Provider Business Practice Location Address
First Line	:	224 GREEN ST
Second Line	:
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892-2000
Country	:	US
Telephone Number	:	252-776-0153
Fax Number	:	252-350-5238

Authorized Official
Title or Position	:	PA-C
Name	:	BRITTANY JAMES WELLS
Credential	:
Telephone Number	:	252-776-0153

Provider Enumeration Date	:	07/09/2025
Last Update Date	:	05/19/2026

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