MEDICARE: MINDFUL AWAKENING, 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	C003625	NC

General Provider Information

NPI Number	:	1720344740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL AWAKENING, PLLC

Provider Business Mailing Address
First Line	:	1703 LEGION RD
Second Line	:	SUITE 204
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-2359
Country	:	US
Telephone Number	:	919-960-1088
Fax Number	:

Provider Business Practice Location Address
First Line	:	1703 LEGION RD
Second Line	:	SUITE 204
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-2359
Country	:	US
Telephone Number	:	919-960-1088
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. KATE A GOTELLI
Credential	:	LCSW
Telephone Number	:	919-960-1088

Provider Enumeration Date	:	04/03/2012
Last Update Date	:	04/03/2012

Similar Medicare Providers

1720088669 — SUSAN A KHAN MA, CCC-SLP
Practice Location Address:

1703 LEGION RD , SUUITE 204
CHAPEL HILL, NC
27517-2359

Practice Phone: 919-932-7160
Practice Fax:

1528017027 — CENTER FOR SPEECH LANGUAGE AND LEARNING
Practice Location Address:

1703 LEGION RD , SUITE 204
CHAPEL HILL, NC
27517-2359

Practice Phone: 919-932-7160
Practice Fax:

1336269349 — DR. KRISTEN C. WYNNS PH.D.
Practice Location Address:

1703 LEGION RD , SUITE 204
CHAPEL HILL, NC
27517-2359

Practice Phone: 919-805-0182
Practice Fax:

1508089251 — DR. TINA LEPAGE PSY.D.
Practice Location Address:

1703 LEGION RD , SUITE 204
CHAPEL HILL, NC
27517-2359

Practice Phone: 919-933-5355
Practice Fax: 919-929-3227

1558636498 — MICHELLE R THELEN L.AC.
Practice Location Address:

1703 LEGION RD , SUITE 206
CHAPEL HILL, NC
27517-2359

Practice Phone: 919-406-4858
Practice Fax:

1326934662 — GRACEFUL NURSES, LLC
Practice Location Address:

32640 THORNCASTLE DR
WESLEY CHAPEL, FL
33545-2359

Practice Phone: 813-729-2176
Practice Fax:

Directions to “MINDFUL AWAKENING, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.