| Piedmont Psychiatric Associates | |
|
2255 Lewisville Clemmons Rd Suite E Clemmons NC 27012-7463 | |
| (336) 766-0505 | |
| (336) 766-0153 |
| Full Name | Piedmont Psychiatric Associates |
|---|---|
| Speciality | Counselor |
| Location | 2255 Lewisville Clemmons Rd, Clemmons, North Carolina |
| Authorized Official Name and Position | William Jeffery Marshall (OWNER) |
| Authorized Official Contact | 3367660505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Piedmont Psychiatric Associates Po Box 874 Clemmons NC 27012-0874 Ph: (336) 766-0505 | Piedmont Psychiatric Associates 2255 Lewisville Clemmons Rd Suite E Clemmons NC 27012-7463 Ph: (336) 766-0505 |
| NPI Number | 1750468328 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 09/28/2011 |
| Medicare PECOS PAC ID | 6002088234 |
|---|---|
| Medicare Enrollment ID | O20111013000065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750468328 | NPI | - | NPPES |
| 7902236 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (North Carolina) | Primary |
| Provider Name | William Jeffery Marshall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104992627 PECOS PAC ID: 7810169042 Enrollment ID: I20111013000082 |
| Provider Name | Barbara O Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548495070 PECOS PAC ID: 2860466166 Enrollment ID: I20130427000009 |
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