Organization
SALEM PSYCHIATRIC ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER MCCAULEY MD (OWNER)
(336) 659-9440
Entity
Organization
Contact information
Practice address
175 KIMEL PARK DR, SUITE 115, WINSTON SALEM, NC 27103-6951
(336) 659-9440
(336) 659-9845
Mailing address
175 KIMEL PARK DR, SUITE 115, WINSTON SALEM, NC 27103-6951
(336) 659-9440
(336) 659-9845
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
20823
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02594
BCBS
NC
05
—
8902594
—
NC
Enumeration date
02/19/2007
Last updated
08/22/2020
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