Organization
EACH ONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY MERCK (OWNER)
(704) 267-1368
Entity
Organization
Contact information
Practice address
4045 UNIVERSITY PKWY STE 252, WINSTON SALEM, NC 27106-3756
(704) 267-1368
Mailing address
4045 UNIVERSITY PKWY STE 252, SUITE 252, WINSTON SALEM, NC 27106-3756
(704) 267-1368
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/16/2025
Last updated
04/08/2026
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