Individual provider Active NPI

Roger Earl Hyman Jr., MS, LPC

  • Professional Counselor
  • Winston Salem, NC
National Provider Identifier
1043424435
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4239 Issued in NC
Practice address
3630 B High Meadows Dr
Winston Salem, NC 27106-4363
Phone
(336) 837-8626
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4239 NC Primary

Addresses

Primary practice location

3630 B High Meadows Dr
Winston Salem, NC 27106-4363

Mailing address

3630 High Meadows Dr Apt B
Winston Salem, NC 27106-4363
Phone (336) 837-8626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221003848 NC Practitioner - Mental Health Counselor 4385088996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Psychiatric and Counseling Center PAGroup PAC ID 3173590882, 23 clinicians

Practice addresses (Care Compare)

603 Dolley Madison Rd
Suite 100
Greensboro, NC 27410-4282
Phone (336) 632-3505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4239NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Psychiatric and Counseling Center PA CurrentSince Jan 1, 2024 Accepting new patients

Locations

603 Dolley Madison Rd
Ste 100
Greensboro, NC 27410
Phone (336) 632-3505

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043424435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 HIGH MEADOWS DR APT B",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064363",
            "telephone_number": "336-837-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 B HIGH MEADOWS DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064363",
            "telephone_number": "336-837-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYMAN",
        "first_name": "ROGER",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.