Healthcare Provider Details

I. General information

NPI: 1679079099
Provider Name (Legal Business Name): GOOD STRESS COMPANY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2018
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 MALLARD CREEK RD STE 104
CHARLOTTE NC
28262-4567
US

IV. Provider business mailing address

10150 MALLARD CREEK RD STE 104
CHARLOTTE NC
28262-4567
US

V. Phone/Fax

Practice location:
  • Phone: 980-242-7090
  • Fax: 980-556-7219
Mailing address:
  • Phone: 980-242-7090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RWENSHAUN MILLER
Title or Position: CEO
Credential: LCMHC
Phone: 919-624-9954