Healthcare Provider Details

I. General information

NPI: 1255261947
Provider Name (Legal Business Name): PLAYFUL MINDS THERAPY & WELLNESS CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 S WHITE ST
WAKE FOREST NC
27587-2916
US

IV. Provider business mailing address

335 S WHITE ST
WAKE FOREST NC
27587-2916
US

V. Phone/Fax

Practice location:
  • Phone: 252-516-5916
  • Fax:
Mailing address:
  • Phone: 252-516-5916
  • 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: RUTH ELENA DEVITO
Title or Position: OWNER
Credential: PHD
Phone: 252-526-5916