Organization
MINDFULLY WE ELEVATE
Active
Other names
Mindfully WE
Organization subpart
No
Provider details
NPI number
Authorized official
QUENETTA M JOHNSON LCMHC (CHIEF EXECUTIVE OFFICER)
(252) 915-0344
Entity
Organization
Contact information
Practice address
4801 GLENWOOD AVE STE 200, RALEIGH, NC 27612-3857
(252) 915-0344
Mailing address
4801 GLENWOOD AVE STE 200, RALEIGH, NC 27612-3857
(252) 915-0344
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/15/2021
Last updated
05/15/2021
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