Organization
GARDEN VILLAGE PSYCHIATRIC AND COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESLIE CAMILLE ONEAL BREWINGTON PMHNP-BC (NURSE PRACTITIONER)
(336) 282-1251
Entity
Organization
Contact information
Practice address
3703 W MARKET ST STE A, GREENSBORO, NC 27403-1300
(336) 282-1251
(336) 282-1252
Mailing address
3703 W MARKET ST STE A, GREENSBORO, NC 27403-1300
(336) 282-1251
(336) 282-1252
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
201644
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201644
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538183447
—
NC
05
—
1912033689
—
NC
Enumeration date
10/16/2017
Last updated
09/08/2023
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