Angela Robin Wyatt Wooten, LCMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11555 Issued in NC

Practice address

276 Old Mocksville Rd Ste 100
Statesville, NC 28625-1951

Phone

(704) 360-3637

Fax

(704) 200-9829

NPI assigned

Apr 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: integrativewellnesssolutions.angelawooten@146232.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Integrative Wellness Solutions, PLLC

  • Psychologist
  • Mooresville, NC
  • NPI 1447760871
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1386039428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 OLD MOCKSVILLE RD STE 100",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251951",
            "telephone_number": "704-360-3637",
            "fax_number": "704-200-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 OLD MOCKSVILLE RD STE 100",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251951",
            "telephone_number": "704-360-3637",
            "fax_number": "704-200-9829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Gateway Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281175544",
            "country_code": "US",
            "telephone_number": "704-360-3637",
            "fax_number": "704-200-9829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "ANGELA",
        "middle_name": "ROBIN WYATT",
        "name_prefix": "Mrs.",
        "credential": "LCMHC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "11555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bob Wodecki, MD
• Shawn Nicholas Wolff, DDS
• Jessica Daniels Wood, FNP
• Kimberly Shores Woods, FNP-C
• Michelle H Woods, PA-C
• Thea Wooten, MA, LCASA
• Whittney Marchelle Work, FNP-C
• Corey A Wright, PHARMD
• Elizabeth Ann Wright, MD
• Emily Wright, CRNA

• Mental Health Counselor in Statesville, NC
• Providers in Statesville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.