| Soulstice Counseling & Wellness, Pllc | |
|
10130 Mallard Creek Rd Ste 300 Charlotte NC 28262-6001 | |
| (980) 272-0352 | |
| (980) 206-0187 |
| Full Name | Soulstice Counseling & Wellness, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 10130 Mallard Creek Rd Ste 300, Charlotte, North Carolina |
| Authorized Official Name and Position | Michele Adriane Lewis (OWNER) |
| Authorized Official Contact | 7047375878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulstice Counseling & Wellness, Pllc 10130 Mallard Creek Rd Charlotte NC 28262-6000 Ph: (980) 272-0352 | Soulstice Counseling & Wellness, Pllc 10130 Mallard Creek Rd Ste 300 Charlotte NC 28262-6001 Ph: (980) 272-0352 |
| NPI Number | 1790372464 |
|---|---|
| Provider Enumeration Date | 12/28/2020 |
| Last Update Date | 03/18/2021 |
| Certification Date | 03/18/2021 |
| Medicare PECOS PAC ID | 5294264818 |
|---|---|
| Medicare Enrollment ID | O20250128002577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790372464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michele A Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700280567 PECOS PAC ID: 4789947805 Enrollment ID: I20180424000486 |
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