| Kim Wilson, Msw, Lcsw, Pllc | |
|
3447 Robinhood Rd Winston Salem NC 27106-4701 | |
| (419) 450-2033 | |
| Not Available |
| Full Name | Kim Wilson, Msw, Lcsw, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3447 Robinhood Rd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Kim Wilson (LCSW) |
| Authorized Official Contact | 4194502033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Wilson, Msw, Lcsw, Pllc 655 N Spring St Winston Salem NC 27101-1326 Ph: (419) 450-2033 | Kim Wilson, Msw, Lcsw, Pllc 3447 Robinhood Rd Winston Salem NC 27106-4701 Ph: (419) 450-2033 |
| NPI Number | 1821621749 |
|---|---|
| Provider Enumeration Date | 02/19/2020 |
| Last Update Date | 02/19/2020 |
| Certification Date | 02/19/2020 |
| Medicare PECOS PAC ID | 0244652667 |
|---|---|
| Medicare Enrollment ID | O20200611003163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821621749 | NPI | - | NPPES |
| 1508341876 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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