Healthcare Provider Details

I. General information

NPI: 1205755964
Provider Name (Legal Business Name): NEUROWELLNESS COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 CONCORD PKWY N STE 100
CONCORD NC
28027-6733
US

IV. Provider business mailing address

8611 CONCORD MILLS BLVD STE 117
CONCORD NC
28027-5400
US

V. Phone/Fax

Practice location:
  • Phone: 704-336-9176
  • Fax:
Mailing address:
  • Phone: 704-336-9176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MELEAH DEMENT
Title or Position: OWNER/CLINICIAN
Credential: LCMHC
Phone: 704-336-9176