Provider Demographics
NPI:1346965415
Name:ROCINANTE HOLISTIC WELLNESS COUNSELING & RECOVERY SERVICES
Entity Type:Organization
Organization Name:ROCINANTE HOLISTIC WELLNESS COUNSELING & RECOVERY SERVICES
Other - Org Name:ROCINANTE HOLISTIC WELLNESS & RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:828-339-1989
Mailing Address - Street 1:6302 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-8629
Mailing Address - Country:US
Mailing Address - Phone:990-339-1989
Mailing Address - Fax:
Practice Address - Street 1:212 S TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28281-0001
Practice Address - Country:US
Practice Address - Phone:704-226-7704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health