Integrative Wellness Solutions, PLLC
Organization Active NPI Psychologist · Mooresville, NC
NPI 1447760871 · NPPES record last updated May 21, 2025
Key facts
- NPI
- 1447760871
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- Legal business name
- INTEGRATIVE WELLNESS SOLUTIONS, PLLC
- Practice address
- 122 Gateway Blvd Ste C
Mooresville, NC 28117-5544 - Phone
- (704) 360-3637
- NPI assigned
- Oct 12, 2017
- Organization subpart
- No
Authorized official
- Name
- Ryan Pardo
- Title
- Chief Legal Officer
- Phone
- (206) 399-1493
Practitioners 223
-
Brianna Nicole Abbate, LCMHCA
-
Kim Addo, LPC, LCMHC
-
Jessica L Agnello, LCMHC
-
Winter Albohaire, LCMHC
-
Faith Todd Allman, MSW, LCSW
-
Obasi Jaheem Amare Jr., LCMHC
-
Donna Nicole Anderson, FNP, PMHNP-BC
-
Sarah Baker, LCSW
-
John Andrew Barber, LMFT
-
Kimberly Carscaddon Barnett, LCMHCA A17316
-
Catherine Mary Bechard, RN, PMHNP-BC
-
Tina Marie Berg, LCMHC
-
Hadley Caitlin Brochu, PSYD
-
Samuel William Bryant, MSW, LCSW
-
Tanya Joy Cass, LPC
-
Nirva Dieubon-Dessalines, PMHNP-BC
-
Brian Distaso, LCMHC
-
Erika Evans-Dort, PMHNP-BC
-
Laquetta Evans, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190618000993 | NC | Part B Supplier - Clinic/Group Practice | 8022341494 |
Receives reassigned benefits from 192 practitioners Practice locations: Statesville, NC; Raleigh, NC; Mooresville, NC; Matthews, NC; Huntersville, NC; Greensboro, NC; Denver, NC; Concord, NC… |
National Provider Directory
Locations
2000 Regency Pkwy
Ste 255
Cary, NC 27518
Phone (888) 693-0435
1942 E 7th St
Ste 220
Charlotte, NC 28204
Phone (704) 777-0693
10430 Harris Oak Blvd
Ste L
Charlotte, NC 28269
Phone (704) 317-2930
925 Bradley St NE
Fl 1
Concord, NC 28025
Phone (980) 766-1030
7490 Waterside Crossing Blvd
Ste 2A
Denver, NC 28037
Phone (980) 800-9380
2530 Meridian Pkwy
Ste 115
Durham, NC 27713
3625 N Elm St
Ste 130
Greensboro, NC 27455
9525 Birkdale Crossing Dr
Ste 300
Huntersville, NC 28078
Phone (704) 317-2930
855 Sam Newell Rd
Ste 100
Matthews, NC 28105
Phone (800) 688-6696
2300 Rexwoods Dr
Ste 140
Raleigh, NC 27607
Phone (910) 554-2488
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Mental Health Counselor |
101YM0800X | |||
| Professional Counselor |
101YP2500X | |||
| Psychologist |
103T00000X | Yes | ||
| Clinical Social Worker |
1041C0700X | |||
| Marriage & Family Therapist |
106H00000X | |||
| Registered Dietitian |
133V00000X | |||
| Psychiatry Physician |
2084P0800X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X |
Addresses
Primary practice location
122 Gateway Blvd Ste C
Mooresville, NC 28117-5544
Mailing address
PO Box 4962
Mooresville, NC 28117-4962
Other practice location 1
276 Old Mocksville Rd Ste 100
Statesville, NC 28625-1951
Phone (704) 360-3637
Other practice location 2
10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513
Phone (704) 360-3637
Other practice location 3
7490 Waterside Crossing Blvd Ste 2A
Denver, NC 28037-3004
Phone (980) 800-9380
Other practice location 4
925 Bradley St
Concord, NC 28025-0911
Phone (704) 360-3637
Other practice location 5
10620 Park Rd Ste 208
Charlotte, NC 28210-0106
Phone (704) 360-3637
Other names
- LifeStance Health
Other providers in Mooresville, NC
- Innovative Physical Therapy Services Inc
- Inpatient Care
- Inspiration for Aspirations
- Inspiration for Aspirations
- Integrative Therapy Concepts
- Integrity Home Mobility, Inc.
- Interventional Pain Management of Lake Norman PLLC
- Eric L Intihar
- Iredell Oral & Facial Surgery PC
- Iredell Physician Network
All providers in Mooresville, NC · Psychologist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.