Healthcare Provider Details

I. General information

NPI: 1659234581
Provider Name (Legal Business Name): KELSIE REBEKAH WOJCUICH LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

749 HALLSVILLE RD
BEULAVILLE NC
28518-6605
US

IV. Provider business mailing address

906 NC 241 HWY
PINK HILL NC
28572-7746
US

V. Phone/Fax

Practice location:
  • Phone: 252-479-2727
  • Fax: 910-375-8108
Mailing address:
  • Phone: 540-617-2014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000041462316
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: