Carmen Ni'Asia Jefferson
Individual provider Active NPI Behavior Technician · Winston Salem, NC
NPI 1083563746 · NPPES record last updated Jan 26, 2026
Key facts
- NPI
- 1083563746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 390 S Liberty St
Winston Salem, NC 27101-5260 - Phone
- (336) 934-4058
- NPI assigned
- Jan 26, 2026
- 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Rehabilitation and Sports Physical Therapy, PC | Single Specialty | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician |
106S00000X | NC | Yes |
Addresses
Primary practice location
390 S Liberty St
Winston Salem, NC 27101-5260
Mailing address
102 Blossom Cir
Lexington, NC 27292-4183
Phone (980) 312-7608
Other providers in Winston Salem, NC
- JC&G Group Homes, LLC
- JCM Advocate Development and Human Services
- JCSW Enterprises, LLC
- Isabel Cristina Jean
- Virginia Wilson Jeffers
- Jeffrey C. Zackeru, DMD, PLLC
- Jeffrey J. Tibbs, DDS, PA
- Calvert Jeffries
- Sonya D H Jeffries
- Tamara L Jenison Williams
All providers in Winston Salem, NC · Behavior Technician 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 26, 2026. 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.