| Catherine Clodfelter Phd Pa | |
|
3000 Bethesda Pl Ste 102 Winston Salem NC 27103-3323 | |
| (336) 965-9944 | |
| (336) 659-9845 |
| Full Name | Catherine Clodfelter Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 3000 Bethesda Pl Ste 102, Winston Salem, North Carolina |
| Authorized Official Name and Position | Catherine Clodfelter (OWNER) |
| Authorized Official Contact | 3366599440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catherine Clodfelter Phd Pa Po Box 24937 Winston Salem NC 27114-4937 Ph: (336) 659-9440 | Catherine Clodfelter Phd Pa 3000 Bethesda Pl Ste 102 Winston Salem NC 27103-3323 Ph: (336) 965-9944 |
| NPI Number | 1578734018 |
|---|---|
| Provider Enumeration Date | 03/12/2008 |
| Last Update Date | 09/02/2010 |
| Medicare PECOS PAC ID | 2163546722 |
|---|---|
| Medicare Enrollment ID | O20100902001052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578734018 | NPI | - | NPPES |
| 0338N | Other | NC | BCBS |
| 600336 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1575 (North Carolina) | Primary |
| Provider Name | Catherine J Clodfelter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255433892 PECOS PAC ID: 1153445713 Enrollment ID: I20100902001071 |
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