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PSYCARE OF THE TRIAD LLP NPI 1720099385


NPI Information

NPI: 1720099385
Provider Name: PSYCARE OF THE TRIAD, LLP
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
661 HARTMAN ST
WINSTON SALEM, NC
ZIP 27127
Phone: (336) 413-3026
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PSYCARE OF THE TRIAD, LLP is a mental health (including community mental health center) clinic center in Winston Salem, NC. PSYCARE OF THE TRIAD, LLP NPI is 1720099385. The provider is registered as an organization entity type.

The provider's business location address is:

661 HARTMAN ST
WINSTON SALEM, NC
ZIP 27127-126
Phone: (336) 413-3026
Fax: (336) 413-3026

The provider's authorized official is Deborea Winfrey .
The authorized official title is Clinical Director and has the following contact phone number (336) 682-7432.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 5/20/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
102884OTHERNORTH CAROLINABCBS
28301783BMEDICAIDNORTH CAROLINA
38301783GMEDICAIDNORTH CAROLINA
4600568MEDICAIDNORTH CAROLINA
52875813MEDICARE ID-TYPE UNSPECIFIED
68301783HMEDICAIDNORTH CAROLINA
76005108MEDICAIDNORTH 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: 4/28/2024

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