Magnolia Behavioral Health, PLLC

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Legal business name

MAGNOLIA BEHAVIORAL HEALTH, PLLC

Doing business as

Magnolia Psychiatry and Mental Wellness

Practice address

602 E Academy St Ste 205
Fuquay Varina, NC 27526-2382

Phone

(919) 635-6202

Fax

(919) 289-1713

NPI assigned

Aug 17, 2023

Last updated

Mar 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacqueline Wenzel, PMHNP-BCNPI 1427670413

Title

Ceo/Owner

Phone

(919) 961-1948

Specialties & licenses 4

Addresses

Other names 1

• Magnolia Psychiatry and Mental Wellness Doing business as

Practitioners 1

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.

• Jacqueline Nicole Wenzel, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fuquay Varina, NC
  • NPI 1427670413

  Registered Nurse

  NPD (past) Authorized official

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1245013770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E ACADEMY ST STE 205",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262382",
            "telephone_number": "919-635-6202",
            "fax_number": "919-289-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E ACADEMY ST STE 205",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262382",
            "telephone_number": "919-635-6202",
            "fax_number": "919-289-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA BEHAVIORAL HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-17",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "WENZEL",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "919-961-1948",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Psychiatry and Mental Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magnolia Psychiatry and Mental Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• M & K Health Services
• Matthew James Macchioni, LPC-A, LCAS-A, NCC
• Rachel Leigh Macko, LCSW
• Ellen Marie Macri
• Alexis Mady, DDS
• Daniel John Mahar, DDS
• Kristin Leigh Main, D.D.S.
• William Paul Mancil, DPT
• Jaqueline Mann
• Sinthia Mannan, MD

• Prevention Professional in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Prevention Professional in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.