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NPI Code Detail

MEDICARE: WISDOM PATH, PLLC

MEDICARE: WISDOM PATH, 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
1101YM0800XMental Health Counselor
2103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1720488414
Entity Type Code : Organization
Provider Name (Legal Business Name) : WISDOM PATH, PLLC
Provider Business Mailing Address
First Line : 220 W UNION ST
Second Line :
City : MORGANTON
State : NC
Zip : 28655-3764
Country : US
Telephone Number : 828-475-6544
Fax Number : 828-475-6545
Provider Business Practice Location Address
First Line : 220 W UNION ST
Second Line :
City : MORGANTON
State : NC
Zip : 28655-3764
Country : US
Telephone Number : 828-475-6544
Fax Number : 828-475-6545
Authorized Official
Title or Position : OWNER
Name : DR. DEBRA PETERS
Credential : PHD
Telephone Number : 828-403-0991
Provider Enumeration Date : 08/29/2014
Last Update Date : 03/31/2025

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1235453960 — MS. JENNIFER M FROYD LCMHC
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Directions to “WISDOM PATH, PLLC ” Practice Location

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