| Metaspace Counseling Pllc | |
|
1400 Old Mill Cir Winston Salem NC 27103-2977 | |
| (336) 997-0408 | |
| Not Available |
| Full Name | Metaspace Counseling Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1400 Old Mill Cir, Winston Salem, North Carolina |
| Authorized Official Name and Position | Alexis N/a Overstreet (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 3363920477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metaspace Counseling Pllc 2504 Newington Ct Clemmons NC 27012-8673 Ph: (336) 392-0477 | Metaspace Counseling Pllc 1400 Old Mill Cir Winston Salem NC 27103-2977 Ph: (336) 997-0408 |
| NPI Number | 1942785068 |
|---|---|
| Provider Enumeration Date | 09/25/2018 |
| Last Update Date | 09/25/2018 |
| Medicare PECOS PAC ID | 2769726686 |
|---|---|
| Medicare Enrollment ID | O20181204002323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942785068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Alexis Overstreet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043690043 PECOS PAC ID: 8729322649 Enrollment ID: I20181204002562 |
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