| Mood Treatment Center, Pllc | |
|
1615 Polo Rd Winston Salem NC 27106-3859 | |
| (336) 722-7266 | |
| (336) 201-0538 |
| Full Name | Mood Treatment Center, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1615 Polo Rd, Winston Salem, North Carolina |
| Authorized Official Name and Position | David Andrew Sack (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3367227266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mood Treatment Center, Pllc 713 S Marshall St Winston Salem NC 27101-5808 Ph: (336) 722-7266 | Mood Treatment Center, Pllc 1615 Polo Rd Winston Salem NC 27106-3859 Ph: (336) 722-7266 |
| NPI Number | 1285867952 |
|---|---|
| Provider Enumeration Date | 08/28/2009 |
| Last Update Date | 07/01/2024 |
| Certification Date | 07/01/2024 |
| Medicare PECOS PAC ID | 6103068598 |
|---|---|
| Medicare Enrollment ID | O20130814000785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285867952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 200100996 (North Carolina) | Primary |
| Provider Name | Christopher B Aiken |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427034768 PECOS PAC ID: 7719889443 Enrollment ID: I20040123000208 |
| Provider Name | Brian Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336461813 PECOS PAC ID: 3072644228 Enrollment ID: I20100701000592 |
| Provider Name | Laura Strickland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568627263 PECOS PAC ID: 9931384146 Enrollment ID: I20110504000292 |
| Provider Name | Jean N Boulet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114179108 PECOS PAC ID: 5799916524 Enrollment ID: I20140320001122 |
| Provider Name | Laura Ann Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770908337 PECOS PAC ID: 5597998864 Enrollment ID: I20140513000296 |
| Provider Name | Adam C Mcdonough |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225349053 PECOS PAC ID: 8325343429 Enrollment ID: I20160229000303 |
| Provider Name | Matthew Thomas Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861762528 PECOS PAC ID: 5799065660 Enrollment ID: I20161212000519 |
| Provider Name | April H Nandigam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043733728 PECOS PAC ID: 1850639022 Enrollment ID: I20190213001868 |
| Provider Name | Susan D Blevins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144771304 PECOS PAC ID: 1254667744 Enrollment ID: I20190722001013 |
| Provider Name | Kyndal Rebecca Auten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578092342 PECOS PAC ID: 7911330311 Enrollment ID: I20191125001891 |
| Provider Name | Joseph Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013571561 PECOS PAC ID: 1456784503 Enrollment ID: I20191216002552 |
| Provider Name | Larisa Rollins King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699314971 PECOS PAC ID: 3173952611 Enrollment ID: I20200403000194 |
| Provider Name | Kadie York |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598396418 PECOS PAC ID: 5496185506 Enrollment ID: I20200413003008 |
| Provider Name | Lisa Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235862251 PECOS PAC ID: 6406230291 Enrollment ID: I20220829000037 |
| Provider Name | Leah Vivian Wolff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740955756 PECOS PAC ID: 9931577376 Enrollment ID: I20221116001628 |
| Provider Name | Deanna Thao La |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962024547 PECOS PAC ID: 7113380411 Enrollment ID: I20230905002160 |
| Provider Name | Danielle P. Kim |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861993511 PECOS PAC ID: 4082062724 Enrollment ID: I20231120000168 |
| Provider Name | Donald Holland |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811929995 PECOS PAC ID: 6002998788 Enrollment ID: I20231120001413 |
| Provider Name | Rebecca Stevens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740782507 PECOS PAC ID: 8527416080 Enrollment ID: I20231122001971 |
| Provider Name | Sheila Shelton Whisenant |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710028063 PECOS PAC ID: 8224486626 Enrollment ID: I20231125000251 |
| Provider Name | Alison Turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295111409 PECOS PAC ID: 8224486352 Enrollment ID: I20231129002203 |
| Provider Name | Cheryl Denine Goldberg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891831277 PECOS PAC ID: 7315398237 Enrollment ID: I20240104003507 |
| Provider Name | Lynda Diane Noffsinger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568694396 PECOS PAC ID: 4183077936 Enrollment ID: I20240129000033 |
| Provider Name | Virginia Ann Brookshire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417363474 PECOS PAC ID: 4587007679 Enrollment ID: I20240206001064 |
| Provider Name | Gregory John Moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982032264 PECOS PAC ID: 3072956945 Enrollment ID: I20240207002724 |
| Provider Name | Jill Elyse Rogers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437568334 PECOS PAC ID: 0648613554 Enrollment ID: I20240207004142 |
| Provider Name | Thomas Shaffer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861789604 PECOS PAC ID: 9032552955 Enrollment ID: I20240208000037 |
| Provider Name | Antonia Glasco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144833302 PECOS PAC ID: 4981047305 Enrollment ID: I20240213000839 |
| Provider Name | Rachel Dimaio Swaim |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427675552 PECOS PAC ID: 3274977640 Enrollment ID: I20240214001559 |
| Provider Name | Esther Simone Whyte |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588159834 PECOS PAC ID: 8729423207 Enrollment ID: I20240226000010 |
| Provider Name | Randy J. Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790745404 PECOS PAC ID: 8729423827 Enrollment ID: I20240228003321 |
| Provider Name | Kalyn Hamilton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891235479 PECOS PAC ID: 1759726623 Enrollment ID: I20240301000379 |
| Provider Name | David A Sack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467657882 PECOS PAC ID: 8628478252 Enrollment ID: I20240404003963 |
Disability Advocacy And Information Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8064 N Point Blvd, Suite 102, Winston Salem, NC 27106 Phone: 336-896-0900 Fax: 336-896-0901 | |
Lyfes New Direction Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 S Marshall St # 65, Winston Salem, NC 27101 Phone: 336-721-4261 Fax: 336-721-4265 | |
Evolve Care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 897 Peters Creek Pkwy Ste 101, Winston Salem, NC 27103 Phone: 336-725-9135 Fax: 336-725-9139 | |
Pinnacle Family Services Of North Carolina Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4035 University Pkwy, Ste 101, Winston Salem, NC 27106 Phone: 336-397-1560 | |
Managing Overwhelming Moments, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1119 Stafford Place Cir Apt 103, Winston Salem, NC 27127 Phone: 919-218-6286 | |
Alexander Youth Network Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8025 N Point Blvd Ste 260, Winston Salem, NC 27106 Phone: 336-724-1412 Fax: 336-724-1464 | |
Daymark Recovery Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 651 Highland Ave, Winston Salem, NC 27101 Phone: 336-657-8523 Fax: 336-723-0645 |