Provider Demographics
NPI:1215693445
Name:AVID WELLNESS COUNSELING AND CONSULTING INC
Entity type:Organization
Organization Name:AVID WELLNESS COUNSELING AND CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-236-4067
Mailing Address - Street 1:1000 COPPERFIELD BLVD NE STE 112
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2454
Mailing Address - Country:US
Mailing Address - Phone:704-236-4067
Mailing Address - Fax:704-445-4582
Practice Address - Street 1:1000 COPPERFIELD BLVD NE STE 112B
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2454
Practice Address - Country:US
Practice Address - Phone:704-236-4067
Practice Address - Fax:704-445-4582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health