| Forsyth Psychiatric Associates, Pllc | |
|
2554 Lewisville Clemmons Rd Ste 209 Clemmons NC 27012-8749 | |
| (336) 660-6000 | |
| Not Available |
| Full Name | Forsyth Psychiatric Associates, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2554 Lewisville Clemmons Rd Ste 209, Clemmons, North Carolina |
| Authorized Official Name and Position | Weiqing Yuan (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3366606000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forsyth Psychiatric Associates, Pllc 2554 Lewisville Clemmons Rd, Suite 209 Clemmons NC 27012 Ph: () - | Forsyth Psychiatric Associates, Pllc 2554 Lewisville Clemmons Rd Ste 209 Clemmons NC 27012-8749 Ph: (336) 660-6000 |
| NPI Number | 1326575994 |
|---|---|
| Provider Enumeration Date | 05/15/2017 |
| Last Update Date | 08/05/2017 |
| Medicare PECOS PAC ID | 7214203405 |
|---|---|
| Medicare Enrollment ID | O20171016000897 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326575994 | NPI | - | NPPES |
| 1700152915 | Medicaid | NC | |
| 1700152915 | Other | PSYCHIATRY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 2015-01825 (North Carolina) | Primary |
| Provider Name | Sophia S Yuan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700152915 PECOS PAC ID: 6406096825 Enrollment ID: I20160726002371 |
| Provider Name | Kayla Gentry Bullard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255909594 PECOS PAC ID: 4688038318 Enrollment ID: I20230914001120 |
| Provider Name | Madeline Gillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427764398 PECOS PAC ID: 5092187625 Enrollment ID: I20231030002810 |
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