MEDICARE: REFLECTIONS WELLNESS COUNSELING, 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1235607631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFLECTIONS WELLNESS COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	4108 PARK RD STE 101
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-4207
Country	:	US
Telephone Number	:	704-326-2252
Fax Number	:

Provider Business Practice Location Address
First Line	:	4108 PARK RD STE 101
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-4207
Country	:	US
Telephone Number	:	704-326-2252
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	REBECCA ROYSTON
Credential	:
Telephone Number	:	704-326-2252

Provider Enumeration Date	:	11/05/2018
Last Update Date	:	09/13/2020

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