| Triad Therapy, Llc | |
|
7830 N Point Blvd Suite 201 Winston Salem NC 27106-3261 | |
| (336) 896-0904 | |
| Not Available |
| Full Name | Triad Therapy, Llc |
|---|---|
| Speciality | Counselor |
| Location | 7830 N Point Blvd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Quincy Rochelle Smiling (CEO) |
| Authorized Official Contact | 3368960904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Triad Therapy, Llc Po Box 12595 Winston Salem NC 27117-2595 Ph: (803) 720-4028 | Triad Therapy, Llc 7830 N Point Blvd Suite 201 Winston Salem NC 27106-3261 Ph: (336) 896-0904 |
| NPI Number | 1881728012 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 02/13/2008 |
| Medicare PECOS PAC ID | 4082798434 |
|---|---|
| Medicare Enrollment ID | O20080225000589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881728012 | NPI | - | NPPES |
| 6006089 | Medicaid | NC |
| Provider Name | Kelly A Virgil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992743991 PECOS PAC ID: 6406863927 Enrollment ID: I20060308000554 |
| Provider Name | Helen Vickers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457439036 PECOS PAC ID: 0840458469 Enrollment ID: I20120228000296 |
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