NPIMap

Organization Active NPI

Be Well Therapy PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1235389248
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6804 Issued in NC
Legal business name
BE WELL THERAPY PLLC
Practice address
1935 J N Pease PL Ste 202
Charlotte, NC 28262-4542
Phone
(704) 334-3170
NPI assigned
Sep 25, 2008
Last updated
Oct 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Authorized official

Name
Rolanda Gabriel, M.A., LPCNPI 1902080641
Title
Licensed Professional Counselor
Phone
(704) 334-3170

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6804 NC Primary

Addresses

Primary practice location

1935 J N Pease PL Ste 202
Charlotte, NC 28262-4542

Mailing address

2128 Commonwealth Ave
Suite E
Charlotte, NC 28205-5126
Phone (704) 334-3170

Other practice location 1

2128 Commonwealth Ave
Suite E
Charlotte, NC 28205-5126
Phone (704) 334-3170

Other identifiers 1

IdentifierTypeStateIssuer
6103780MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241126000008 NC Part B Supplier - Clinic/Group Practice 1355876574 Receives reassigned benefits from 5 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory
Tax ID family
Be Well Therapy PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1935 J N Pease Pl
Ste 202
Charlotte, NC 28262
Phone (704) 334-3170

2128 Commonwealth Ave
Ste E
Charlotte, NC 28205
Phone (704) 334-3170

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729814400000",
    "number": "1235389248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 COMMONWEALTH AVE",
            "address_2": "SUITE E",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055126",
            "telephone_number": "704-334-3170",
            "fax_number": "704-334-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 J N PEASE PL STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624542",
            "telephone_number": "704-334-3170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2128 Commonwealth Ave",
            "address_2": "Suite E",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282055126",
            "country_code": "US",
            "telephone_number": "704-334-3170",
            "fax_number": "704-334-3181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BE WELL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ROLANDA",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "704-334-3170",
        "authorized_official_credential": "M.A., LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "6804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103780",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.