MODERN WELLNESS PLLC NPI 1144496365

NPI Information

  • NPI: 1144496365
  • Provider Name: MODERN WELLNESS PLLC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 1107F W BROAD ST
    ELIZABETHTOWN, NC
    ZIP 28337
  • Phone: (910) 862-4009

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NPI Details

MODERN WELLNESS PLLC is a professional counselor in Elizabethtown, NC. MODERN WELLNESS PLLC NPI is 1144496365. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1107F W BROAD ST
ELIZABETHTOWN, NC
ZIP 28337-483
Phone: (910) 862-4009
Fax: (910) 862-6004

The provider's authorized official is Kristi Starr Baldwin Rooks .
The authorized official title is Owner and has the following contact phone number (910) 914-0011.

The enumeration date for this NPI number is 5/7/2008 and was last updated on 5/7/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessional3512NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1APPLYING FORMEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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