Individual
DR. GEORGE CAMPBELL HAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D., LPC
Contact information
Practice address
665 W 4TH ST, WINSTON SALEM, NC 27101-2701
(336) 725-8389
Mailing address
1514 BERWICK RD, WINSTON SALEM, NC 27103-4704
(336) 760-0567
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2165
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165
STATE COUNSELING LICENSE
NC
Enumeration date
03/16/2007
Last updated
07/08/2007
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