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Organization

ESSENTIAL WELLNESS COUNSELING PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TYEEKIA BLUE LCSW, LCAS (PSYCHOTHERAPIST)
(980) 236-1704
Entity
Organization

Contact information

Practice address
4350 MAIN ST STE 213, HARRISBURG, NC 28075-7448
(980) 236-1704
(980) 206-0709
Mailing address
4350 MAIN ST STE 213, HARRISBURG, NC 28075-7448
(980) 236-1704
(980) 206-0709

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1083153563
NC
Enumeration date
06/12/2020
Last updated
06/12/2020
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