MEDICARE: PLAYFUL MINDS THERAPY & WELLNESS CENTER, 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	:	1255261947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAYFUL MINDS THERAPY & WELLNESS CENTER, PLLC

Provider Business Mailing Address
First Line	:	335 S WHITE ST
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-2916
Country	:	US
Telephone Number	:	252-516-5916
Fax Number	:

Provider Business Practice Location Address
First Line	:	335 S WHITE ST
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-2916
Country	:	US
Telephone Number	:	252-516-5916
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RUTH ELENA DEVITO
Credential	:	PHD
Telephone Number	:	252-526-5916

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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