MEDICARE: ATHELAS COUNSELING & WELLNESS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1164282166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATHELAS COUNSELING & WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	8404 DUCKWOOD LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-8050
Country	:	US
Telephone Number	:	704-214-4127
Fax Number	:

Provider Business Practice Location Address
First Line	:	19501 W CATAWBA AVE STE 280
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-4067
Country	:	US
Telephone Number	:	704-770-5818
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH COUNSELOR
Name	:	MOLLY HURST
Credential	:
Telephone Number	:	704-770-5818

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	05/14/2024

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