Organization
A PENNY FOR YOUR THOUGHTS, PLLC
Active
Parent organization
MIND & BODY RENEW MEDICAL SPA AND PSYCHIATRY
Other names
Mind & Body Renew Medical Spa and Psychiatry
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIND & BODY RENEW MEDICAL SPA AND PSYCHIATRY
Authorized official
CHARISSE FULLWOOD PMHNP-BC (CEO)
(910) 713-8209
Entity
Organization
Contact information
Practice address
3200 BLUE RIDGE RD STE 218, RALEIGH, NC 27612-8087
(910) 713-8209
(833) 542-8310
Mailing address
3200 BLUE RIDGE RD STE 218, RALEIGH, NC 27612-8087
(910) 713-8209
(833) 542-8310
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
261Q00000X
Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/25/2026
Last updated
04/25/2026
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