Provider Demographics
NPI:1407629769
Name:WILHELMENA CONSULTANT AND RESEARCH AGENCY, PLLC
Entity Type:Organization
Organization Name:WILHELMENA CONSULTANT AND RESEARCH AGENCY, PLLC
Other - Org Name:THE WILHELMENA AGENGY, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:WILHELMENA
Authorized Official - Last Name:MCCORMICK-DUNLAP
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:704-891-5694
Mailing Address - Street 1:5009 BEATTIES FORD RD STE 107-114
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-2859
Mailing Address - Country:US
Mailing Address - Phone:704-891-5694
Mailing Address - Fax:
Practice Address - Street 1:5009 BEATTIES FORD RD STE 107-114
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-2859
Practice Address - Country:US
Practice Address - Phone:704-891-5694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILHELMENA CONSULTANT AND RESEARCH AGENCY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-30
Last Update Date:2023-11-08
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
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No251V00000XAgenciesVoluntary or Charitable
No261QA0900XAmbulatory Health Care FacilitiesClinic/CenterAmputeeGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty