Goldstar Counseling & Wellness Center | |
24 Battleground Ct Ste A Greensboro NC 27408-2103 | |
(336) 907-4054 | |
(336) 276-0018 |
Full Name | Goldstar Counseling & Wellness Center |
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Speciality | Community/Behavioral Health |
Location | 24 Battleground Ct Ste A, Greensboro, North Carolina |
Authorized Official Name and Position | Latasha M Carter (OWNER) |
Authorized Official Contact | 3369074054 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Goldstar Counseling & Wellness Center 24 Battleground Ct Ste A Greensboro NC 27408-2103 Ph: (336) 907-4054 | Goldstar Counseling & Wellness Center 24 Battleground Ct Ste A Greensboro NC 27408-2103 Ph: (336) 907-4054 |
NPI Number | 1124473335 |
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Provider Enumeration Date | 04/26/2016 |
Last Update Date | 11/10/2022 |
Certification Date | 10/02/2020 |
Medicare PECOS PAC ID | 0840563672 |
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Medicare Enrollment ID | O20170830001229 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124473335 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | C009356 (North Carolina) | Primary |
Provider Name | Regina Mozingo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255669529 PECOS PAC ID: 4981832508 Enrollment ID: I20140106000314 |
Provider Name | Latasha Carter |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1992135594 PECOS PAC ID: 2860774866 Enrollment ID: I20170830001572 |
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