Provider Demographics
NPI:1427529155
Name:WELLNESS WITHIN PROFESSIONAL COUNSELING
Entity type:Organization
Organization Name:WELLNESS WITHIN PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DUNAVANT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:252-339-4915
Mailing Address - Street 1:111 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:NC
Mailing Address - Zip Code:27974-6241
Mailing Address - Country:US
Mailing Address - Phone:252-339-4915
Mailing Address - Fax:
Practice Address - Street 1:2400 N CROATAN HWY STE F
Practice Address - Street 2:
Practice Address - City:KILL DEVIL HILLS
Practice Address - State:NC
Practice Address - Zip Code:27948-9356
Practice Address - Country:US
Practice Address - Phone:252-339-4915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty