| Mood Treatment Center, Pllc | |
|
1615 Polo Rd Winston Salem NC 27106-3859 | |
| (336) 722-7266 | |
| (336) 201-0538 |
| Full Name | Mood Treatment Center, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1615 Polo Rd, Winston Salem, North Carolina |
| Authorized Official Name and Position | David Andrew Sack (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5629653193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mood Treatment Center, Pllc 1615 Polo Rd Winston Salem NC 27106-3831 Ph: (336) 722-7266 | Mood Treatment Center, Pllc 1615 Polo Rd Winston Salem NC 27106-3859 Ph: (336) 722-7266 |
| NPI Number | 1285867952 |
|---|---|
| Provider Enumeration Date | 08/28/2009 |
| Last Update Date | 10/09/2025 |
| Certification Date | 10/09/2025 |
| Medicare PECOS PAC ID | 6103068598 |
|---|---|
| Medicare Enrollment ID | O20130814000785 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285867952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 200100996 (North Carolina) | Primary |
| Provider Name | Erica E Herman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275827990 PECOS PAC ID: 0749411254 Enrollment ID: I20140326002009 |
| Provider Name | April H Nandigam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043733728 PECOS PAC ID: 1850639022 Enrollment ID: I20190213001868 |
| Provider Name | Joseph Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013571561 PECOS PAC ID: 1456784503 Enrollment ID: I20191216002552 |
| Provider Name | Kadie York |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598396418 PECOS PAC ID: 5496185506 Enrollment ID: I20200413003008 |
| Provider Name | Lisa Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235862251 PECOS PAC ID: 6406230291 Enrollment ID: I20220829000037 |
| Provider Name | Hilary B Puzak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659004927 PECOS PAC ID: 7113394974 Enrollment ID: I20221209002225 |
| Provider Name | Mikaela Reese Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043910185 PECOS PAC ID: 6709242043 Enrollment ID: I20230511003056 |
| Provider Name | David A Sack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467657882 PECOS PAC ID: 8628478252 Enrollment ID: I20240404003963 |
| Provider Name | Yulia Abair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265085286 PECOS PAC ID: 2365773504 Enrollment ID: I20241230001183 |
| Provider Name | Fernando P Grabner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104321389 PECOS PAC ID: 9335481670 Enrollment ID: I20250429004129 |
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