| Novant Health Forsyth Behavioral Health Outpatient | |
|
175 Kimel Park Dr Suite 100 Winston Salem NC 27103-6951 | |
| (336) 277-1800 | |
| (336) 277-6981 |
| Full Name | Novant Health Forsyth Behavioral Health Outpatient |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 175 Kimel Park Dr, Winston Salem, North Carolina |
| Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
| Authorized Official Contact | 7043166081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Novant Health Forsyth Behavioral Health Outpatient Po Box 75216 Charlotte NC 28275-0216 Ph: (704) 384-9144 | Novant Health Forsyth Behavioral Health Outpatient 175 Kimel Park Dr Suite 100 Winston Salem NC 27103-6951 Ph: (336) 277-1800 |
| NPI Number | 1346427200 |
|---|---|
| Provider Enumeration Date | 01/23/2008 |
| Last Update Date | 07/10/2023 |
| Certification Date | 07/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346427200 | NPI | - | NPPES |
| 89012TT | Medicaid | NC | |
| 89012TT | Other | NC | BCBS GRP ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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