MEDICARE: PONCE WELLNESS 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

General Provider Information

NPI Number	:	1770438848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PONCE WELLNESS PLLC

Provider Business Mailing Address
First Line	:	107 BELL TOWER WAY
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-5519
Country	:	US
Telephone Number	:	919-943-9885
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 BELL TOWER WAY
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-5519
Country	:	US
Telephone Number	:	919-943-9885
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	EVELYN PONCE QUINTERO
Credential	:	LCSW
Telephone Number	:	919-943-9885

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “PONCE WELLNESS PLLC ” Practice Location

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