Provider Demographics
NPI:1699340844
Name:CAROLINA WELLNESS SOLUTIONS COUNSELING AND CONSULTING PLLC
Entity type:Organization
Organization Name:CAROLINA WELLNESS SOLUTIONS COUNSELING AND CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:SMETAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:704-648-3420
Mailing Address - Street 1:100 GLENWAY ST STE F
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3174
Mailing Address - Country:US
Mailing Address - Phone:704-674-7290
Mailing Address - Fax:
Practice Address - Street 1:100 GLENWAY ST STE F
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3174
Practice Address - Country:US
Practice Address - Phone:704-674-7290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty