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Organization

PSYCARE OF THE TRIAD, LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEBOREA WINFREY PHD (CLINICAL DIRECTOR)
(336) 682-7432
Entity
Organization

Contact information

Practice address
661 HARTMAN ST, WINSTON SALEM, NC 27127-7126
(336) 413-3026
(336) 413-3026
Mailing address
661 HARTMAN ST, WINSTON SALEM, NC 27127-7126
(336) 413-3026
(336) 413-3026

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02884
BCBS
NC
05
6005108
NC
05
600568
NC
05
8301783B
NC
05
8301783G
NC
05
8301783H
NC
Enumeration date
08/10/2006
Last updated
05/20/2010
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