# CLEMONS RESILIENCY & WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407623549
- **Authorized official:** MR. MATTHEW ANTOINNE CLEMONS NURSE PRACTITIONER (OWNER)
- **Authorized official phone:** (919) 306-6074

## Contact information

- **Practice address:** 833 WAKE FOREST BUSINESS PARK STE F, WAKE FOREST, NC 27587-7184
- **Practice address phone:** (919) 368-8839
- **Mailing address:** 1404 THE PINES PL, WAKE FOREST, NC 27587-1742
- **Mailing address phone:** (919) 306-6074
- **Mailing address fax:** (984) 297-8776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | — | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2023
- **Last updated:** 04/05/2024