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General NPI Number Information
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NPI Number | 1780281766
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Entity Type | Organization
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Legal Business Name | BUILT FOR MENTAL WELLNESS, PC
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Dates
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Enumeration Date | 10/03/2020
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 4801 GLENWOOD AVE STE 200
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City | RALEIGH
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State | NC
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Zip | 27612-3857
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Country | US
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Telephone | 252-751-0243
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Fax | 252-351-0316
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Provider Business Mailing Address
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Address Line | PO BOX 30594
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City | GREENVILLE
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State | NC
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Zip | 27833-0594
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Country | US
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Telephone | 252-751-0243
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Fax | 252-351-0316
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Authorized Official
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Title or Position | THERAPIST
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Name | ZANDY EVANS
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Credential | LMFT
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Telephone | 252-751-0243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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