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General NPI Number Information
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NPI Number | 1629554027
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Entity Type | Organization
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Legal Business Name | WELLNESS COUNSELING PLLC
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Dates
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Enumeration Date | 07/18/2018
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 5269 US HIGHWAY 158
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City | ADVANCE
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State | NC
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Zip | 27006-6905
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Country | US
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Telephone | 336-486-7306
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Fax |
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Provider Business Mailing Address
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Address Line | 5269 US HIGHWAY 158
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City | ADVANCE
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State | NC
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Zip | 27006-6905
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Country | US
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Telephone | 703-489-1303
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | CELINE BONGAERTS
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Credential | LPC
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Telephone | 336-486-7306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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