Provider Demographics
NPI:1679334676
Name:WHOLE MENTALITY PLLC
Entity type:Organization
Organization Name:WHOLE MENTALITY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, TRAUMA THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:KENDRA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:984-325-6889
Mailing Address - Street 1:2920 FORESTVILLE ROAD
Mailing Address - Street 2:STE 100 PMB 1256
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:620 W LANE ST STE 202
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1441
Practice Address - Country:US
Practice Address - Phone:984-325-6889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty