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NPI Code Detail

MEDICARE: EXISTENTIAL WELLNESS LLC

MEDICARE: EXISTENTIAL WELLNESS LLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1619638681
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXISTENTIAL WELLNESS LLC
Provider Business Mailing Address
First Line : 20468 CHARTWELL CENTER DR STE N
Second Line :
City : CORNELIUS
State : NC
Zip : 28031-9642
Country : US
Telephone Number : 704-775-9211
Fax Number :
Provider Business Practice Location Address
First Line : 20468 CHARTWELL CENTER DR STE N
Second Line :
City : CORNELIUS
State : NC
Zip : 28031-9642
Country : US
Telephone Number : 704-997-8273
Fax Number :
Authorized Official
Title or Position : COUNSELOR
Name : MR. JOSEPH ANTHONY SAGLIMBENI II
Credential : LCMHC-A, NCC
Telephone Number : 704-775-9211
Provider Enumeration Date : 01/03/2022
Last Update Date : 07/20/2022

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