Provider Demographics
NPI:1437167673
Name:MCLEOD CENTERS FOR WELLBEING
Entity Type:Organization
Organization Name:MCLEOD CENTERS FOR WELLBEING
Other - Org Name:MCLEOD CENTERS FOR WELLBEING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE MANAGEMEN
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CHILDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-332-9001
Mailing Address - Street 1:500 ARCHDALE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-4217
Mailing Address - Country:US
Mailing Address - Phone:704-332-9001
Mailing Address - Fax:704-332-0124
Practice Address - Street 1:500 ARCHDALE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-4217
Practice Address - Country:US
Practice Address - Phone:704-332-9001
Practice Address - Fax:704-332-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-060-010101YA0400X
NCMHL-060-880101YA0400X
NCMHL-036-100101YA0400X
NCMHL-018-057101YA0400X
NCMHL-095-036101YA0400X
NCMHL-059-024101YA0400X
NCMHL-049-101101YA0400X
NCMHL-060-1206251S00000X
NC1208251S00000X
NC1209251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300412Medicaid
NC8300666Medicaid
NC8301345Medicaid
NC8300516Medicaid
NC8301102Medicaid
NC8301309Medicaid