Magnolia Wellness Group, PC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MAGNOLIA WELLNESS GROUP, PC

Practice address

1904 Eastwood Rd Ste 313
Wilmington, NC 28403-5728

Phone

(910) 375-7500

NPI assigned

Dec 10, 2018

Organization subpart

No

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

Authorized official

Name

Jeffrey Litzinger, MDNPI 1316918170

Title

Medical Director

Phone

(910) 375-7500

Specialties & licenses 2

Addresses

Other names 1

• Magnolia Mental Health Associates, PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 3

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

• Natalie David, LCSW

  • Clinical Social Worker
  • Rolling Hills, CA
  • NPI 1235580853

  NC

  Medicare reassignment NPD
• Jeffrey Litzinger, M.D.

  • Child & Adolescent Psychiatry Physician
  • Los Alamitos, CA
  • NPI 1316918170
  NPD Authorized official
• Brenda Bambino Knierim, LCSW

  • Clinical Social Worker
  • Hampstead, NC
  • NPI 1679896120
  NPD (past)

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1982175469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 WILD TURKEY PL",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284054265",
            "telephone_number": "910-375-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 EASTWOOD RD STE 313",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035728",
            "telephone_number": "910-375-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA WELLNESS GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "LITZINGER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "910-375-7500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Mental Health Associates, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• William Seth Magin, M.D.
• Anthony Maglione, M.D.
• Mindy R Maglione, NP
• Magnolia Counseling and Wellness, PLLC
• Magnolia Family Medicine PC
• Michelle Maguire, MSW LCSW
• Patrick David Maguire, M.D.
• Melissa Maillard
• Mainstreet and Kidsstreet of North Carolina PLLC
• Mainstreet and Kidsstreet of North Carolina PLLC

• All providers in Wilmington, NC
• Adolescent and Children Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.