Provider Demographics
NPI:1003556473
Name:RALEIGH WELLNESS BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:RALEIGH WELLNESS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:NEKETA HARRIS
Authorized Official - Last Name:PARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-589-1204
Mailing Address - Street 1:4909 WATERS EDGE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2462
Mailing Address - Country:US
Mailing Address - Phone:919-589-1204
Mailing Address - Fax:919-589-1264
Practice Address - Street 1:4909 WATERS EDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2462
Practice Address - Country:US
Practice Address - Phone:919-589-1204
Practice Address - Fax:919-589-1264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty