| Brian Distaso, LCMHC | |
|
855 Sam Newell Rd Ste 100, Matthews, NC 28105-7593 | |
| (704) 360-3637 | |
| Not Available |
| Full Name | Brian Distaso |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 855 Sam Newell Rd Ste 100, Matthews, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528890704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 17591 (North Carolina) | Primary |
| 101YP2500X | Counselor - Professional | 17591 (North Carolina) | Secondary |
| Entity Name | Integrative Wellness Solutions Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447760871 PECOS PAC ID: 8022341494 Enrollment ID: O20190618000993 |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Distaso, LCMHC 6016 Storehouse Rd, Mint Hill, NC 28227-9294 Ph: () - | Brian Distaso, LCMHC 855 Sam Newell Rd Ste 100, Matthews, NC 28105-7593 Ph: (704) 360-3637 |
Esther Nam, LCMHC Counselor Medicare: Medicare Enrolled Practice Location: 855 Sam Newell Rd Ste 100, Matthews, NC 28105 Phone: 704-360-3637 | |
Courtney Michelle Caveny, MA, LMFT Counselor Medicare: Medicare Enrolled Practice Location: 1401 Matthews Township Pkwy Ste 320, Matthews, NC 28105 Phone: 704-384-1261 Fax: 704-384-3145 | |
Ashlyn B Sexton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1320 Matthews Mint Hill Rd, Matthews, NC 28105 Phone: 704-844-6958 | |
Mrs. Shirley A. Bird, M.A., LPC, LPC#1015 Counselor Medicare: Not Enrolled in Medicare Practice Location: 325 Matthews Mint Hill Rd Ste 102, Matthews, NC 28105 Phone: 704-819-3288 Fax: 704-372-1055 | |
Mrs. Shannon Marie Berger, MED., LPCA, LCMHCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 5005 Cinnamon Dr, Matthews, NC 28104 Phone: 828-388-2399 | |
Jenna Lane, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9719 Northeast Pkwy, Matthews, NC 28105 Phone: 704-443-8148 | |
Adria Goulet, LCSWA Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Matthews Station St, Matthews, NC 28105 Phone: 980-299-7436 |