Healthcare Provider Details

I. General information

NPI: 1710578638
Provider Name (Legal Business Name): BREATHE THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S MAIN ST
WAKE FOREST NC
27587-9335
US

IV. Provider business mailing address

12329 PAWLEYS MILL CIR
RALEIGH NC
27614-7979
US

V. Phone/Fax

Practice location:
  • Phone: 919-438-2941
  • Fax:
Mailing address:
  • Phone: 919-438-2941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KRISTA HELLER
Title or Position: OUTPATIENT MENTAL HEALTH THERAPIST
Credential: MSW, LCSW
Phone: 919-438-2941