Organization
BRIGHTWATER WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA DANIELLE PARKER LCSW (OWNER/THERAPIST)
(910) 233-3644
Entity
Organization
Contact information
Practice address
300 S MAIN ST STE 212, HOLLY SPRINGS, NC 27540-4201
(919) 295-6485
Mailing address
300 S MAIN ST STE 212, HOLLY SPRINGS, NC 27540-4201
(919) 295-6485
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC1900X
Counseling Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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