Healthcare Provider Details

I. General information

NPI: 1528556909
Provider Name (Legal Business Name): ANNA PLYLER WEDDINGTON LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 COUNCIL ST APT 205
WILMINGTON NC
28403-0390
US

IV. Provider business mailing address

636 COUNCIL ST APT 205
WILMINGTON NC
28403-0390
US

V. Phone/Fax

Practice location:
  • Phone: 910-547-8831
  • Fax:
Mailing address:
  • Phone: 910-547-8831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9188
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9188
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: