Provider Demographics
NPI:1386373728
Name:WISE MINDS COUNSELING PLLC
Entity type:Organization
Organization Name:WISE MINDS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCS
Authorized Official - Phone:828-652-1517
Mailing Address - Street 1:715 HIDDEN VIEW LOOP
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-8474
Mailing Address - Country:US
Mailing Address - Phone:828-652-1517
Mailing Address - Fax:828-559-2091
Practice Address - Street 1:2301 RUTHERFORD RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-4894
Practice Address - Country:US
Practice Address - Phone:828-652-1517
Practice Address - Fax:828-559-2091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1700031275OtherBCBS, UHC, MEDCOST, TRI CARE, AETNA
NC1356913032OtherBCBS, UHC, MEDCOST, TRI CARE, AETNA