Organization
GENESIS BALANCE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON WIGGINS LCSW (OWNER)
(910) 708-6025
Entity
Organization
Contact information
Practice address
2545 RAVENHILL DR STE 102, FAYETTEVILLE, NC 28303-5460
(910) 708-6025
(910) 858-5876
Mailing address
2545 RAVENHILL DR STE 102, FAYETTEVILLE, NC 28303-5460
(910) 708-6025
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/25/2019
Last updated
02/19/2024
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