Healthcare Provider Details

I. General information

NPI: 1376405381
Provider Name (Legal Business Name): INNER LIGHT MEDITATION AND COUNSELING CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2025
Last Update Date: 11/27/2025
Certification Date: 11/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N EDGEWORTH ST STE 101
GREENSBORO NC
27401-2183
US

IV. Provider business mailing address

7 BROOKGLEN CT
GREENSBORO NC
27410-2758
US

V. Phone/Fax

Practice location:
  • Phone: 336-543-6624
  • Fax: 336-856-1704
Mailing address:
  • Phone: 336-543-6624
  • Fax: 336-856-1704

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 Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ROSSANA L MAGALHAESE
Title or Position: MENTAL HEALTH COUNSELOR
Credential: MS, EDS
Phone: 336-543-6624