Woodlake Psychological And Psychiatric Associates, Pllc | |
725 W Main St Jamestown NC 27282-7506 | |
(336) 889-6800 | |
(336) 889-6800 |
Full Name | Woodlake Psychological And Psychiatric Associates, Pllc |
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Speciality | Social Worker |
Location | 725 W Main St, Jamestown, North Carolina |
Authorized Official Name and Position | Sheila Stone Polinsky (OFFICE MANAGER) |
Authorized Official Contact | 3368896800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Woodlake Psychological And Psychiatric Associates, Pllc Po Box 772 Jamestown NC 27282-0772 Ph: (336) 889-6800 | Woodlake Psychological And Psychiatric Associates, Pllc 725 W Main St Jamestown NC 27282-7506 Ph: (336) 889-6800 |
NPI Number | 1154375236 |
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Provider Enumeration Date | 05/21/2006 |
Last Update Date | 12/01/2009 |
Medicare PECOS PAC ID | 9638230931 |
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Medicare Enrollment ID | O20081204000874 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154375236 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 1242 (North Carolina) | Secondary |
1041C0700X | Social Worker - Clinical | COOO666 (North Carolina) | Primary |
Provider Name | Sheila S Polinsky |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1063466142 PECOS PAC ID: 1355402652 Enrollment ID: I20081218000741 |
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