Healthcare Provider Details

I. General information

NPI: 1346175338
Provider Name (Legal Business Name): BEHAVIORAL MENTAL HEALTH WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 HARDAWAY PT
CLAYTON NC
27527-5572
US

IV. Provider business mailing address

421 HARDAWAY PT
CLAYTON NC
27527-5572
US

V. Phone/Fax

Practice location:
  • Phone: 919-292-5101
  • Fax:
Mailing address:
  • Phone: 919-292-5101
  • 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: BINDU MASON
Title or Position: NP
Credential:
Phone: 919-292-5101