Healthcare Provider Details

I. General information

NPI: 1376057406
Provider Name (Legal Business Name): VERITAS COLLABORATIVE CHARLOTTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2017
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SCOTT AVENUE SUITE 101
CHARLOTTE NC
28203
US

IV. Provider business mailing address

1295 BANDANA BLVD. SUITE 210
ST.PAUL MN
55108
US

V. Phone/Fax

Practice location:
  • Phone: 888-364-5977
  • Fax:
Mailing address:
  • Phone: 866-364-5977
  • Fax: 919-908-9778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSIE MORCHING
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 888-364-5977