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General NPI Number Information
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NPI Number | 1336726116
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Entity Type | Organization
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Legal Business Name | BEST LIFE MENTAL HEALTH & WELLNESS PLLC
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 202 WILLIAMSON RD STE 204
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City | MOORESVILLE
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State | NC
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Zip | 28117-7610
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Country | US
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Telephone | 704-992-7584
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Fax | 704-992-7899
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Provider Business Mailing Address
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Address Line | 202 WILLIAMSON RD STE 204
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City | MOORESVILLE
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State | NC
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Zip | 28117-7610
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Country | US
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Telephone | 704-992-7584
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Fax | 704-992-7899
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | CHRISTOPHER BRADLEY
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Credential | PA
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Telephone | 704-992-7584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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