Provider Demographics
NPI:1144811126
Name:MINDFUL ELEVATION COUNSELING AND WELLNESS, PLLC
Entity type:Organization
Organization Name:MINDFUL ELEVATION COUNSELING AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, EMPLOYEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:MEDLIN
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAS
Authorized Official - Phone:910-639-6636
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:EAGLE SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27242-0278
Mailing Address - Country:US
Mailing Address - Phone:910-639-6636
Mailing Address - Fax:910-974-8090
Practice Address - Street 1:980 7 LKS N STE 6
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-9752
Practice Address - Country:US
Practice Address - Phone:910-639-6636
Practice Address - Fax:910-974-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty