MEDICARE: THERAPYWELL 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	:	1477404747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPYWELL PLLC

Provider Business Mailing Address
First Line	:	6432 ASTOR ELGIN ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-6738
Country	:	US
Telephone Number	:	540-604-4159
Fax Number	:

Provider Business Practice Location Address
First Line	:	6432 ASTOR ELGIN ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-6738
Country	:	US
Telephone Number	:	540-604-4159
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	TEADORA SEIDORF
Credential	:	MSW, LCSWA
Telephone Number	:	540-604-4159

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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