ASHLEYBROOK CLINIC PA NPI 1699828475

NPI Information

NPI: 1699828475
Provider Name: ASHLEYBROOK CLINIC PA
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1321 ASHLEYBROOK LANE
WINSTON SALEM, NC
ZIP 27103
Phone: (336) 659-9045
Get Directions

ASHLEYBROOK CLINIC PA is a mental health counselor in Winston Salem, NC. ASHLEYBROOK CLINIC PA NPI is 1699828475. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1321 ASHLEYBROOK LANE
WINSTON SALEM, NC
ZIP 27103-918
Phone: (336) 659-9045
Fax: (336) 659-7866

The provider's authorized official is Thai T Phan .
The authorized official title is President and has the following contact phone number (336) 659-9045.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 8/1/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	28930	NORTH CAROLINA	No
2	208VP0000X	Pain Medicine	Pain Medicine	28930	NORTH CAROLINA	No
3	101YM0800X	Counselor	Mental Health	28930	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C23975	MEDICARE UPIN	NORTH CAROLINA
2	0152F	OTHER	NORTH CAROLINA	BCBS
3	2309000	MEDICARE PIN	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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