Healthcare Provider Details

I. General information

NPI: 1528985736
Provider Name (Legal Business Name): HEATHER COLENDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3804 PARK AVE STE C
WILMINGTON NC
28403-6737
US

IV. Provider business mailing address

813 PORTERS NECK RD
WILMINGTON NC
28411-7615
US

V. Phone/Fax

Practice location:
  • Phone: 910-240-4473
  • Fax:
Mailing address:
  • Phone:
  • 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:
Title or Position:
Credential:
Phone: