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General NPI Number Information
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NPI Number | 1831915511
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Entity Type | Organization
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Legal Business Name | REBIRTH-HEART AND MIND PLLC
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 351 WAGONER DR STE 411
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-4608
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Country | US
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Telephone | 910-302-7226
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Fax | 910-222-3017
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Provider Business Mailing Address
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Address Line | PO BOX 1684
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City | HOPE MILLS
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State | NC
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Zip | 28348-1506
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Country | US
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Telephone | 910-302-7226
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Fax | 910-222-3017
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BRITTANY WHARTON
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Credential | LCSW, LCAS
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Telephone | 910-302-7226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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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