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Organization

DYNAMIC MENTAL HEALTH GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRYSTAL RAMEY LPC (VICE PRESIDENT)
(336) 970-1174
Entity
Organization

Contact information

Practice address
1670 LOWERY ST, WINSTON SALEM, NC 27101-5603
(336) 970-1174
Mailing address
PO BOX 24872, WINSTON SALEM, NC 27114-4872
(336) 970-1174
(336) 768-4578

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
7895
NC
2084P0800X
Psychiatry Physician
5902401
NC
305S00000X
Point of Service
Primary
PC10377
NC

Other

Enumeration date
01/09/2011
Last updated
01/22/2011
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