Marysabel Vasquez, LMFT
Individual provider Active NPI Marriage & Family Therapist · Winston Salem, NC
NPI 1053968255 · NPPES record last updated Jan 17, 2023
Key facts
- NPI
- 1053968255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 2380 (NC)
- Practice address
- 1001 Reynolda Rd
Winston Salem, NC 27104-3245 - Phone
- (336) 721-7600
- NPI assigned
- Aug 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2380 | NC | MD | Behavioral Analyst |
| 12155A | NC | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossnore Communities for Children | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/tcrossn-80dcacc1
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 12155A | NC | |
| Marriage & Family Therapist | 106H00000X | 2380 | NC | Yes |
Addresses
Primary practice location
1001 Reynolda Rd
Winston Salem, NC 27104-3245
Mailing address
1001 Reynolda Rd
Winston Salem, NC 27104-3245
Phone (336) 721-7600
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mvasquez@crossnore.org | Crossnore Communities for Children |
Other providers in Winston Salem, NC
- Paige Elizabeth Varga
- Robert M Varnell
- Michael John Varney
- Christopher Andrew Vasil
- Desmond Vasquez
- Garrett Anderson Vass
- Sujethra Vasu
- Mihaela Alina Vatca
- David Michael Vaughan
- Elizabeth Vaughan
All providers in Winston Salem, NC · Marriage & Family Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.