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Organization
PSYCARE OF THE TRIAD, LLP
Active
Organization
PSYCARE OF THE TRIAD, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBOREA WINFREY PHD (CLINICAL DIRECTOR)
(336) 682-7432
Entity
Organization
Contact information
Practice address
661 HARTMAN ST, WINSTON SALEM, NC 27127-7126
(336) 413-3026
(336) 413-3026
Mailing address
661 HARTMAN ST, WINSTON SALEM, NC 27127-7126
(336) 413-3026
(336) 413-3026
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02884
BCBS
NC
05
—
6005108
—
NC
05
—
600568
—
NC
05
—
8301783B
—
NC
05
—
8301783G
—
NC
05
—
8301783H
—
NC
Enumeration date
08/10/2006
Last updated
05/20/2010
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