| Lifechanges Family Guidance & Wellness Inc. | |
|
1922 Mlk Jr. Drive Winston Salem NC 27107-1361 | |
| (336) 776-3154 | |
| (336) 464-2071 |
| Full Name | Lifechanges Family Guidance & Wellness Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1922 Mlk Jr. Drive, Winston Salem, North Carolina |
| Authorized Official Name and Position | Latrina Devonne Winford (CEO) |
| Authorized Official Contact | 3365776652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifechanges Family Guidance & Wellness Inc. 1922 S Martin Luther King Jr Dr Ste 15 Winston Salem NC 27107-1371 Ph: (336) 464-1322 | Lifechanges Family Guidance & Wellness Inc. 1922 Mlk Jr. Drive Winston Salem NC 27107-1361 Ph: (336) 776-3154 |
| NPI Number | 1417148420 |
|---|---|
| Provider Enumeration Date | 08/05/2007 |
| Last Update Date | 07/06/2026 |
| Certification Date | 07/06/2026 |
| Medicare PECOS PAC ID | 1557712627 |
|---|---|
| Medicare Enrollment ID | O20240112003153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417148420 | NPI | - | NPPES |
| GP8090 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251B00000X | Case Management | (South Carolina) | Secondary |
| Provider Name | Latrina Devonne Winford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306036470 PECOS PAC ID: 1850474750 Enrollment ID: I20240408000343 |
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