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General NPI Number Information
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NPI Number | 1104773167
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Entity Type | Organization
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Legal Business Name | WHOLISTIC HEALTH AND WELLNESS PLLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 258 SOUTHTOWN CIR
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City | ROLESVILLE
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State | NC
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Zip | 27571-9593
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Country | US
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Telephone | 919-922-5030
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 71
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City | ROLESVILLE
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State | NC
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Zip | 27571-0071
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Country | US
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Telephone | 984-222-9767
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHANNON FAIN
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Credential | LCSW
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Telephone | 984-222-9767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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