Organization Active NPI

Simply Well Therapy, PLLC

  • Adult Mental Health Clinic/Center
  • Raleigh, NC
National Provider Identifier
1497422703
Registry record updated Dec 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SIMPLY WELL THERAPY, PLLC
Practice address
4070 Barrett Dr
Raleigh, NC 27609-6604
Phone
(919) 410-6566
NPI assigned
Aug 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2021

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

Authorized official

Name
Mallori ThompsonNPI 1154099208
Title
General Manager
Phone
(919) 410-6566

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

4070 Barrett Dr
Raleigh, NC 27609-6604

Mailing address

4070 Barrett Dr
Raleigh, NC 27609-6604
Phone (919) 410-6566

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639180800000",
    "number": "1497422703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 BARRETT DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096604",
            "telephone_number": "919-410-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 BARRETT DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096604",
            "telephone_number": "919-410-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY WELL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-12-11",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "MALLORI",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "919-410-6566"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2021; 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.