Provider Demographics
NPI:1396478178
Name:WELLNESS & SUPPORT COUNSELING PLLC
Entity type:Organization
Organization Name:WELLNESS & SUPPORT COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:REAVES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCMHC, NCC
Authorized Official - Phone:828-380-5839
Mailing Address - Street 1:615 RIVER HIGHWAY
Mailing Address - Street 2:PMB 1072
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9286
Mailing Address - Country:US
Mailing Address - Phone:828-838-9932
Mailing Address - Fax:
Practice Address - Street 1:16TH AVE SE
Practice Address - Street 2:207A
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-2861
Practice Address - Country:US
Practice Address - Phone:828-380-5839
Practice Address - Fax:704-973-7865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty