Healthcare Provider Details

I. General information

NPI: 1649468562
Provider Name (Legal Business Name): THE FAMILY WELLNESS CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 W MAIN ST SUITE 205
WASHINGTON NC
27889-4882
US

IV. Provider business mailing address

7062 CHERRY RUN RD
WASHINGTON NC
27889-8398
US

V. Phone/Fax

Practice location:
  • Phone: 252-948-3692
  • Fax: 252-948-3693
Mailing address:
  • Phone: 252-814-5464
  • Fax: 252-948-3693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1133
License Number StateNC

VIII. Authorized Official

Name: MR. DAVID EUGENE BELL II
Title or Position: DIRECTOR/NC LICENSED MFT
Credential: M.S., LMFT
Phone: 252-814-5464