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HEADSPACE & WELLNESS CLINIC PLLC
NPI 1811680390
Nurse Practitioner - Psychiatric/Mental Health in Clemmons, NC

Active since May 31, 2023
2509A LEWISVILLE CLEMMONS RD # 1012, CLEMMONS, NC 27012(704) 703-3417 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 2, 2025, Jul 11, 2023, May 31, 2023 (3 updates tracked since 2023).

About Headspace & Wellness Clinic Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEADSPACE & WELLNESS CLINIC PLLC (NPI 1811680390) is a healthcare organization registered as a psychiatric/mental health in Clemmons, North Carolina and active in the NPI registry since May 2023. The organization maintains a secondary practice location in Advance and lists Martha L Eseh, Managing Director, as its authorized official.

NPPES Registry Identity

NPI1811680390
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameHEADSPACE & WELLNESS CLINIC PLLC
Location Address2509A LEWISVILLE CLEMMONS RD # 1012Clemmons, NC 27012-8712
Mailing Address196 Arnold Palmer DrAdvance, NC 27006-7310 · (804) 350-5824
Phone(704) 703-3417
Organization SubpartNo
Authorized OfficialMartha L EsehManaging Director · (804) 350-5824
Enumeration DateMay 31, 2023
Last NPPES UpdateSeptember 2, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2025
✔ NPI 1811680390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedRegistered Nurse · Psychiatric/Mental Health, AdultTaxonomy 163WP0809X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
2509A LEWISVILLE CLEMMONS RD # 1012, Clemmons, NC 27012
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Secondary Practice Location 1

Location 1196 Arnold Palmer DrAdvance, NC 27006-7310 · Phone (804) 350-5824

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Headspace & Wellness Clinic PLLC's NPI number?

The NPI number for Headspace & Wellness Clinic PLLC is 1811680390. It was assigned to this organization in the NPPES registry on May 31, 2023.

Where is Headspace & Wellness Clinic PLLC located?

Headspace & Wellness Clinic PLLC is located at 2509A Lewisville Clemmons Rd # 1012, Clemmons, NC 27012. The listed phone number is (704) 703-3417.

What is Headspace & Wellness Clinic PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Headspace & Wellness Clinic PLLC was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.