Healthcare Provider Details

I. General information

NPI: 1952057341
Provider Name (Legal Business Name): ART OF WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S ESTES DR STE 206
CHAPEL HILL NC
27514-2866
US

IV. Provider business mailing address

1710 E FRANKLIN ST # 1097
CHAPEL HILL NC
27514-5851
US

V. Phone/Fax

Practice location:
  • Phone: 919-636-9170
  • Fax:
Mailing address:
  • Phone: 919-636-9170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ZUMRAT AHMEDJANOVA
Title or Position: OWNER/CEO
Credential: MSW, LCSW, LCAS
Phone: 919-636-9170