Organization Active NPI

Well-Life Counseling & Spiritual Center

  • Clinical Social Worker
  • Rocky Mount, NC
National Provider Identifier
1083166227
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009720 Issued in NC
Legal business name
WELL-LIFE COUNSELING & SPIRITUAL CENTER
Practice address
301 S Church St Ste 254
Rocky Mount, NC 27804-5749
Phone
(252) 557-3901
NPI assigned
Nov 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shameca D Ricks, LCSWNPI 1205278298
Title
Owner
Phone
(252) 557-3901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C009720 NC Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

301 S Church St Ste 254
Rocky Mount, NC 27804-5749

Mailing address

301 S Church St Ste 254
Rocky Mount, NC 27804-5749
Phone (252) 557-3901

National Provider Directory

National Provider Directory

Locations

301 S Church St
Ste 254
Rocky Mount, NC 27804
Phone (252) 557-3901

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1083166227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S CHURCH ST STE 254",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278045749",
            "telephone_number": "252-557-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S CHURCH ST STE 254",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278045749",
            "telephone_number": "252-557-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL-LIFE COUNSELING & SPIRITUAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "SHAMECA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-557-3901",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009720",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.