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Individual

DR. TIMOTHY NORRIS WEBSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
160 KIMEL FOREST DR, STE 100, WINSTON SALEM, NC 27103-6074
(336) 770-6451
(336) 714-6475
Mailing address
160 KIMEL FOREST DR, STE 100, WINSTON SALEM, NC 27103-6074
(336) 770-6451
(336) 714-6475

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
635
NC
103T00000X
Psychologist
Primary
635
NC
103TB0200X
Cognitive & Behavioral Psychologist
635
NC
103TC0700X
Clinical Psychologist
635
NC
103TH0100X
Health Service Psychologist
635
NC
103TP2701X
Group Psychotherapy Psychologist
635
NC
103TR0400X
Rehabilitation Psychologist
635
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04862
BCBS PROVIDER ID
NC
05
6000280
NC
Enumeration date
04/19/2006
Last updated
10/18/2013
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