MEDICARE: INTEGRATIVE WELLNESS AND THERAPEUTICS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133VN1004X	Pediatric Nutrition Registered Dietitian
2	224Z00000X	Occupational Therapy Assistant
3	235Z00000X	Speech-Language Pathologist
4	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1750042974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE WELLNESS AND THERAPEUTICS, PLLC

Provider Business Mailing Address
First Line	:	19901 W CATAWBA AVE STE 104
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-4040
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19901 W CATAWBA AVE STE 104
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-4040
Country	:	US
Telephone Number	:	704-610-8250
Fax Number	:

Authorized Official
Title or Position	:	OWNER, CEO
Name	:	SAMANTHA HEIDENREICH
Credential	:	OTD
Telephone Number	:	843-267-3361

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	01/10/2022

Similar Medicare Providers

1417663659 — DOMINIQUE CORREA LCMHC
Practice Location Address:

19901 W CATAWBA AVE STE 102
CORNELIUS, NC
28031-4040

Practice Phone: 804-613-4812
Practice Fax:

1023503828 — IESHA TERESA LEE WILLIAMS LCMHC, LCAS-A,
Practice Location Address:

19901 W CATAWBA AVE STE 102
CORNELIUS, NC
28031-4040

Practice Phone: 980-217-8678
Practice Fax:

1265184261 — STACIE MARIE POMPILI
Practice Location Address:

19901 W CATAWBA AVE STE 102
CORNELIUS, NC
28031-4040

Practice Phone: 855-284-7483
Practice Fax: 617-807-0958

1437893724 — KARSEN SAWYER
Practice Location Address:

19901 W CATAWBA AVE STE 104
CORNELIUS, NC
28031-4040

Practice Phone: 704-610-8250
Practice Fax:

1487393229 — CHLOE PAULSEN
Practice Location Address:

19901 W CATAWBA AVE STE 102
CORNELIUS, NC
28031-4040

Practice Phone: 855-675-4144
Practice Fax: 617-807-0958

1699521377 — LUCIA ELIZABETH SCIRE COTA/L
Practice Location Address:

19901 W CATAWBA AVE STE 104
CORNELIUS, NC
28031-4040

Practice Phone: 704-610-8250
Practice Fax:

Directions to “INTEGRATIVE WELLNESS AND THERAPEUTICS, 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.