Patricia Ann Blum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008311 Issued in NC

Practice address

713 S Marshall St
Winston Salem, NC 27101-5808

Phone

(336) 722-7266

Fax

(336) 201-0538

NPI assigned

Sep 12, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Patricia Ann Goral Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Wellmood PLLC

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1154182368
  NPD (past)

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1104176791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 S MARSHALL ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015808",
            "telephone_number": "336-722-7266",
            "fax_number": "336-201-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 S MARSHALL ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015808",
            "telephone_number": "336-722-7266",
            "fax_number": "336-201-0538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 N Peace Haven Rd",
            "address_2": "Ste 104",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271064850",
            "country_code": "US",
            "telephone_number": "248-798-5394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Highland Ave",
            "address_2": "2ND FLOOR",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271014206",
            "country_code": "US",
            "telephone_number": "336-607-8501",
            "fax_number": "336-725-4030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUM",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "GORAL",
            "middle_name": "ANN",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blue State Wellness and Recovery
• Alena Noelani Blue
• Carla Blue, OT/L
• Cherese Smith Blue, LCMHCA
• Joann Marie Bluj, MD
• Howard Andrew Blumstein, MD
• Patricia Elizabeth Board, LPC-A, LCAS-A
• Brendan James Boatman
• Rachel C Bobbitt
• Mackenzie Boccardo

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.