Provider Demographics
NPI:1578235156
Name:COMPLETE PEACE, PLLC
Entity Type:Organization
Organization Name:COMPLETE PEACE, PLLC
Other - Org Name:SARA ROSS DBA COMPLETE PEACE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:REBEKAH
Authorized Official - Last Name:WHITLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-489-1886
Mailing Address - Street 1:PO BOX 135
Mailing Address - Street 2:
Mailing Address - City:BAT CAVE
Mailing Address - State:NC
Mailing Address - Zip Code:28710-0135
Mailing Address - Country:US
Mailing Address - Phone:828-222-7949
Mailing Address - Fax:844-234-7856
Practice Address - Street 1:212 S GROVE ST STE F
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-4006
Practice Address - Country:US
Practice Address - Phone:828-489-1886
Practice Address - Fax:844-234-7856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1649721911OtherNPI