Healthcare Provider Details

I. General information

NPI: 1700346277
Provider Name (Legal Business Name): WELL BALANCED COUNSELING AND CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S MAIN ST
MOUNT HOLLY NC
28120-2021
US

IV. Provider business mailing address

PO BOX 391
MC ADENVILLE NC
28101-0391
US

V. Phone/Fax

Practice location:
  • Phone: 704-228-9289
  • Fax:
Mailing address:
  • Phone: 704-228-9289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. KELLY CARPENTER
Title or Position: OWNER
Credential: LCSW
Phone: 704-228-9289