| Integrative Wellness Solutions | |
|
122 Gateway Blvd Mooresville NC 28117-5543 | |
| (704) 360-3637 | |
| Not Available |
| Full Name | Integrative Wellness Solutions |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 122 Gateway Blvd, Mooresville, North Carolina |
| Authorized Official Name and Position | Asheli M Thompson (OWNER) |
| Authorized Official Contact | 7043603637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrative Wellness Solutions Po Box 4962 Mooresville NC 28117-4962 Ph: (704) 360-3637 | Integrative Wellness Solutions 122 Gateway Blvd Mooresville NC 28117-5543 Ph: (704) 360-3637 |
| NPI Number | 1073955621 |
|---|---|
| Provider Enumeration Date | 07/24/2013 |
| Last Update Date | 04/25/2019 |
| Medicare PECOS PAC ID | 4688982507 |
|---|---|
| Medicare Enrollment ID | O20160106002738 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073955621 | NPI | - | NPPES |
| Provider Name | Elizabeth Jane Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194150011 PECOS PAC ID: 8527295278 Enrollment ID: I20131230000899 |
| Provider Name | Courtney Huffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720429715 PECOS PAC ID: 2668780792 Enrollment ID: I20151008003161 |
| Provider Name | Jessica A Burkley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710379011 PECOS PAC ID: 3476833054 Enrollment ID: I20161219000700 |
| Provider Name | Jessica N Crowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164824843 PECOS PAC ID: 9638450802 Enrollment ID: I20161229001731 |
| Provider Name | Heather Rikli Semmens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275068165 PECOS PAC ID: 2668741547 Enrollment ID: I20170710000000 |
| Provider Name | Annsley K Ulrich |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1417497363 PECOS PAC ID: 4880966068 Enrollment ID: I20170823001434 |
| Provider Name | Samuel M Rosen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306250949 PECOS PAC ID: 8921372137 Enrollment ID: I20170926002925 |
| Provider Name | Sue Ann Bingham Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013054105 PECOS PAC ID: 9931465069 Enrollment ID: I20171107000005 |
| Provider Name | Nicole Atkinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649684044 PECOS PAC ID: 6002240587 Enrollment ID: I20191217001841 |
| Provider Name | Robert Bruce Risavi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144530940 PECOS PAC ID: 4082048319 Enrollment ID: I20191219002151 |
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