| Woodlake Psychological And Psychiatric Associates, Pllc | |
|
725 W Main St Jamestown NC 27282-7506 | |
| (336) 889-6800 | |
| (336) 889-6800 |
| Full Name | Woodlake Psychological And Psychiatric Associates, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 725 W Main St, Jamestown, North Carolina |
| Authorized Official Name and Position | Sheila Stone Polinsky (OFFICE MANAGER) |
| Authorized Official Contact | 3368896800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodlake Psychological And Psychiatric Associates, Pllc Po Box 772 Jamestown NC 27282-0772 Ph: (336) 889-6800 | Woodlake Psychological And Psychiatric Associates, Pllc 725 W Main St Jamestown NC 27282-7506 Ph: (336) 889-6800 |
| NPI Number | 1154375236 |
|---|---|
| Provider Enumeration Date | 05/21/2006 |
| Last Update Date | 12/01/2009 |
| Medicare PECOS PAC ID | 9638230931 |
|---|---|
| Medicare Enrollment ID | O20081204000874 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154375236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1242 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | COOO666 (North Carolina) | Primary |
| Provider Name | Sheila S Polinsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063466142 PECOS PAC ID: 1355402652 Enrollment ID: I20081218000741 |
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