Individual
ANN DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
936 W 4TH ST, WINSTON-SALEM, NC 27101-2564
(336) 655-5702
(336) 724-2706
Mailing address
PO BOX 21283, WINSTON SALEM, NC 27120-1283
(336) 655-5702
(336) 724-2706
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2052
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1333F
BLUE CROSS/BLUE SHEILD
NC
05
—
6102668
—
NC
Enumeration date
05/18/2006
Last updated
10/26/2007
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