Providential Care: Center for Mental Wellness, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PROVIDENTIAL CARE: CENTER FOR MENTAL WELLNESS, PLLC

Practice address

3340B Ellsworth Dr
Greenville, NC 27834-4944

Phone

(252) 917-8182

NPI assigned

Feb 3, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Richelle Lafaye Smallwood, LCSWNPI 1124408190

Title

Owner, Clinician

Phone

(252) 315-8081

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

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

• Richelle Lafaye Smallwood, LCSW

  • Clinical Social Worker
  • Greenville, NC
  • NPI 1124408190
  NPD Authorized official

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1750034294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30882",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278330882",
            "telephone_number": "252-917-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340B ELLSWORTH DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344944",
            "telephone_number": "252-917-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENTIAL CARE: CENTER FOR MENTAL WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "SMALLWOOD",
        "authorized_official_first_name": "RICHELLE",
        "authorized_official_middle_name": "LAFAYE",
        "authorized_official_title_or_position": "OWNER, CLINICIAN",
        "authorized_official_telephone_number": "252-315-8081",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richellesmallwood@providentialcare.hush.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3340B Ellsworth Dr",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278344944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Greenville, NC
• Providers in Greenville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.