Organization
MIND GARDEN ROANOKE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CELIA MCCAULEY-WITTL DNP, FNP-BC (OWNER/OPERATOR)
(540) 765-8696
Entity
Organization
Contact information
Practice address
402 CAMPBELL AVE SW, ROANOKE, VA 24016-3627
(540) 765-8696
Mailing address
402 CAMPBELL AVE SW, ROANOKE, VA 24016-3627
(540) 765-8696
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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