Provider Demographics
NPI:1427770684
Name:ENLIGHTENED COUNSELING AND WELLNESS PLLC
Entity type:Organization
Organization Name:ENLIGHTENED COUNSELING AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ ORGANIZER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HALBREONDA
Authorized Official - Middle Name:MCNEILL
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-224-3077
Mailing Address - Street 1:701 SPENCER LN
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-0012
Mailing Address - Country:US
Mailing Address - Phone:704-224-3077
Mailing Address - Fax:
Practice Address - Street 1:705 S MAIN ST STE 7
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-4915
Practice Address - Country:US
Practice Address - Phone:704-269-8773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty