Healthcare Provider Details
I. General information
NPI: 1255199295
Provider Name (Legal Business Name): ODYSSEY PSYCHIATRY AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2024
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8502 SIX FORKS RD STE 102
RALEIGH NC
27615-3264
US
IV. Provider business mailing address
8502 SIX FORKS RD STE 102
RALEIGH NC
27615-3264
US
V. Phone/Fax
- Phone: 984-207-1098
- Fax: 984-202-2194
- Phone: 984-207-1098
- Fax: 984-202-2194
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEGAN
ZARTMAN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 984-207-1098