# GARDEN VILLAGE PSYCHIATRIC AND COUNSELING SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396256426
- **Authorized official:** MRS. LESLIE CAMILLE ONEAL BREWINGTON PMHNP-BC (NURSE PRACTITIONER)
- **Authorized official phone:** (336) 282-1251

## Contact information

- **Practice address:** 3703 W MARKET ST STE A, GREENSBORO, NC 27403-1300
- **Practice address phone:** (336) 282-1251
- **Practice address fax:** (336) 282-1252
- **Mailing address:** 3703 W MARKET ST STE A, GREENSBORO, NC 27403-1300
- **Mailing address phone:** (336) 282-1251
- **Mailing address fax:** (336) 282-1252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | 201644 | NC | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 201644 | NC | Yes |

## Other

- **Enumeration date:** 10/16/2017
- **Last updated:** 09/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1538183447 | — | NC |
| 05 | — | 1912033689 | — | NC |