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NPI Code Detail

MEDICARE: MIND-BODY CONNECTION COUNSELING PLLC

MEDICARE: MIND-BODY CONNECTION 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1699543876
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIND-BODY CONNECTION COUNSELING PLLC
Provider Business Mailing Address
First Line : PO BOX 146
Second Line :
City : BALSAM
State : NC
Zip : 28707-0146
Country : US
Telephone Number : 828-283-0113
Fax Number : 828-246-0254
Provider Business Practice Location Address
First Line : 626 N MAIN ST
Second Line :
City : WAYNESVILLE
State : NC
Zip : 28786-3820
Country : US
Telephone Number : 828-283-0113
Fax Number : 828-246-0254
Authorized Official
Title or Position : SOLE MEMBER
Name : MARIA AVERZA
Credential : LCMHC
Telephone Number : 828-233-0113
Provider Enumeration Date : 12/18/2023
Last Update Date : 01/06/2024

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Directions to “MIND-BODY CONNECTION COUNSELING PLLC ” Practice Location

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