Provider Demographics
NPI:1770379620
Name:THREE STRAND WELLNESS
Entity type:Organization
Organization Name:THREE STRAND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-938-5001
Mailing Address - Street 1:1515 MOCKINGBIRD LN STE 360
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-1172
Mailing Address - Country:US
Mailing Address - Phone:980-938-5001
Mailing Address - Fax:980-999-5022
Practice Address - Street 1:1515 MOCKINGBIRD LN STE 360
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-1172
Practice Address - Country:US
Practice Address - Phone:980-938-5001
Practice Address - Fax:980-999-5022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty