Individual provider Active NPI

Teresa Whitley Tindall, LPC

  • Mental Health Counselor
  • Winston Salem, NC
National Provider Identifier
1154436376
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4740 Issued in NC
Practice address
8025 N Point Blvd Ste 231
Winston Salem, NC 27106-3288
Phone
(336) 896-0065
Fax
(336) 896-0710
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

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
Mental Health Counselor 101YM0800X 4740 NC Primary

Addresses

Primary practice location

8025 N Point Blvd Ste 231
Winston Salem, NC 27106-3288

Mailing address

8025 N Point Blvd Ste 231
Winston Salem, NC 27106-3288
Phone (336) 896-0065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4740NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Christian Counseling Past Accepting new patients

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154436376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 N POINT BLVD STE 231",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063288",
            "telephone_number": "336-896-0065",
            "fax_number": "336-896-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8025 N POINT BLVD STE 231",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063288",
            "telephone_number": "336-896-0065",
            "fax_number": "336-896-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINDALL",
        "first_name": "TERESA",
        "middle_name": "WHITLEY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.