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General NPI Number Information
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NPI Number | 1629851605
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Entity Type | Organization
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Legal Business Name | PAINTING MIRACLES INC.
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Dates
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Enumeration Date | 08/15/2023
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Last Update Date | 04/27/2025
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Provider Practice Location Address
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Address Line | 1248 FORT BRAGG RD STE 200
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-4982
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Country | US
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Telephone | 910-339-2121
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Fax | 910-229-3331
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Provider Business Mailing Address
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Address Line | 1248 FORT BRAGG RD STE 200
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-4982
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Country | US
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Telephone | 910-339-2121
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Fax | 910-229-3331
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Authorized Official
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Title or Position | PSYCHOLOGIST/CEO
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Name | CARMELITA TIBURCIO BIGELOW
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Credential | PHD
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Telephone | 910-777-4887
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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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Taxonomy #2
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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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