Provider Demographics
NPI:1346837358
Name:RESTORATION AND WELLNESS COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:RESTORATION AND WELLNESS COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBNAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, LCAS-A
Authorized Official - Phone:919-791-8202
Mailing Address - Street 1:PO BOX 40635
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27629-0635
Mailing Address - Country:US
Mailing Address - Phone:919-791-8202
Mailing Address - Fax:
Practice Address - Street 1:6849 LAKINSVILLE LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-6910
Practice Address - Country:US
Practice Address - Phone:919-791-8202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty