Healthcare Provider Details

I. General information

NPI: 1730060864
Provider Name (Legal Business Name): BREATHE AGAIN COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17154 SAND BANK RD
CHARLOTTE NC
28278-5024
US

IV. Provider business mailing address

17154 SAND BANK RD
CHARLOTTE NC
28278-5024
US

V. Phone/Fax

Practice location:
  • Phone: 301-542-4714
  • Fax:
Mailing address:
  • Phone: 301-542-4714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHANDRA WILKERSON
Title or Position: PSYCHOTHERAPIST
Credential:
Phone: 301-542-4714