Healthcare Provider Details

I. General information

NPI: 1205742699
Provider Name (Legal Business Name): UNRAVELING COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 EASTWOOD RD
WILMINGTON NC
28403-3654
US

IV. Provider business mailing address

1800 EASTWOOD RD
WILMINGTON NC
28403-3654
US

V. Phone/Fax

Practice location:
  • Phone: 336-528-4014
  • Fax: 910-558-0809
Mailing address:
  • Phone: 336-528-4014
  • Fax: 910-558-0809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY BRADLEY
Title or Position: OWNER
Credential: LCMHC, LCAS
Phone: 336-528-4014