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Organization
HEARTWOOD PERFORMANCE, PLLC
Active
Organization
HEARTWOOD PERFORMANCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN FOODMAN LSCW (OWNER)
(704) 418-1333
Entity
Organization
Contact information
Practice address
5960 FAIRVIEW RD STE 400, CHARLOTTE, NC 28210-3119
(704) 476-5575
Mailing address
15720 BRIXHAM HILL AVE, CHARLOTTE, NC 28277-4651
(704) 476-5575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C010390
NC
Other
Enumeration date
06/25/2018
Last updated
09/13/2021
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