Healthcare Provider Details

I. General information

NPI: 1063209286
Provider Name (Legal Business Name): HESED COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 RANDALL PKWY STE 102
WILMINGTON NC
28403-2845
US

IV. Provider business mailing address

5002 RANDALL PKWY STE 102
WILMINGTON NC
28403-2845
US

V. Phone/Fax

Practice location:
  • Phone: 910-627-5524
  • Fax: 910-900-7634
Mailing address:
  • Phone: 910-627-5524
  • Fax: 910-900-7634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAYLA BROOKE MORENO VEGA
Title or Position: OWNER, CHILD AND FAMILY THERAPIST
Credential: MSW, LCSW
Phone: 910-627-5524