Provider Demographics
NPI:1154905271
Name:DIMENSIONS OF WELLNESS LLC
Entity type:Organization
Organization Name:DIMENSIONS OF WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DESI
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCKOY
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCA
Authorized Official - Phone:980-254-1755
Mailing Address - Street 1:2800 ZEBULON AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208
Mailing Address - Country:US
Mailing Address - Phone:980-254-1755
Mailing Address - Fax:
Practice Address - Street 1:2800 ZEBULON AVE STE 204
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208
Practice Address - Country:US
Practice Address - Phone:980-254-1755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty