Indigo Integrative Psychiatry and Wellness

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

INDIGO INTEGRATIVE PSYCHIATRY AND WELLNESS

Practice address

4030 Wake Forest Rd
Raleigh, NC 27609-0010

Phone

(828) 419-4490

NPI assigned

Oct 9, 2024

Organization subpart

No

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

Authorized official

Name

Misty Stills, PA-C

Title

Owner

Phone

(828) 419-4490

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1902625569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276090010",
            "telephone_number": "828-419-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276090010",
            "telephone_number": "828-419-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO INTEGRATIVE PSYCHIATRY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "STILLS",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-419-4490",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independence Human Services, Inc.
• Independent Living Technologies Inc.
• Independent Nephrology Services, Inc.
• Independent Personal Training Studios
• Independently Moving, LLC
• Indigo Legends Enterprise LLC
• Indigo Medical, PLLC
• Infinite Favor Home Care Services LLC
• Infinity Growth, a Psychotherapy Practice PLLC
• Infinity Wellness Solutions

• Adult Mental Health Clinic/Center in Raleigh, NC
• Providers in Raleigh, 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 Oct 9, 2024; 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.