Mental Wellness Clinical Counseling and Services

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

MENTAL WELLNESS CLINICAL COUNSELING AND SERVICES

Doing business as

Mental Wellness Clinical Counseling and Services

Practice address

127 Goldsboro St S
Wilson, NC 27893-4903

Phone

(252) 469-7007

NPI assigned

Feb 5, 2021

Last updated

Aug 22, 2023By 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

Shirria McCullough, LCSW

Title

Owner

Phone

(252) 469-7007

Specialties & licenses 1

Addresses

Other names 1

• Mental Wellness Clinical Counseling and Services Doing business as

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1265024863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 FARMWOOD LOOP",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278968005",
            "telephone_number": "252-469-7007",
            "fax_number": "252-371-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 GOLDSBORO ST S",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934903",
            "telephone_number": "252-469-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL WELLNESS CLINICAL COUNSELING AND SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-05",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "SHIRRIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-469-7007",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental Wellness Clinical Counseling and Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mental Wellness Clinical Counseling and Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Traci Melton
• Al Leodus Melvin, MD
• Samantha Yvette Mendoza Thomas, MS, CCC-SLP
• Coraleisha Antoinette Mendoza, MSW, LCSW
• Patricia Maria Mendoza, FNP-C
• Axel Luis Mercado, PA C
• Debra Bunn Mercer, RPH
• Rubi Baltazar Merino
• Metanoia LLC
• Margaret Metts, M.D.

• Adult Mental Health Clinic/Center in Wilson, NC
• Providers in Wilson, NC by specialty
• Adult Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.