Healthcare Provider Details

I. General information

NPI: 1730808916
Provider Name (Legal Business Name): SALTMARSH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 08/23/2022
Certification Date: 08/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 RANDALL PKWY
WILMINGTON NC
28403-2829
US

IV. Provider business mailing address

5010 RANDALL PKWY
WILMINGTON NC
28403-2829
US

V. Phone/Fax

Practice location:
  • Phone: 910-791-5719
  • Fax:
Mailing address:
  • Phone: 910-791-5719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSA BAREFOOT
Title or Position: OWNER, THERAPIST
Credential: MSW, LCSW
Phone: 910-622-6418