Organization
CENTRAL PIEDMONT ACCESS II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM GRAHAM (EXECUTIVE DIRECTOR)
(336) 716-5654
Entity
Organization
Contact information
Practice address
1920 W 1ST ST, FLOOR 5, WINSTON SALEM, NC 27104-4220
(336) 716-5654
(336) 716-2683
Mailing address
PO BOX 15046, WINSTON SALEM, NC 27113-0046
(336) 716-5654
(336) 716-2683
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C001547
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005896
—
NC
Enumeration date
02/12/2007
Last updated
08/22/2020
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