Provider Demographics
NPI:1124618905
Name:WHOLE PERSON WELLNESS PLLC
Entity type:Organization
Organization Name:WHOLE PERSON WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICAL PROVIDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:LEVETTE
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:252-343-4800
Mailing Address - Street 1:1206 STONERIDGE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-9640
Mailing Address - Country:US
Mailing Address - Phone:252-343-4800
Mailing Address - Fax:
Practice Address - Street 1:420 S MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-0016
Practice Address - Country:US
Practice Address - Phone:252-343-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty