Active NPI
Thomas E Dougherty Jr., PH.D.
- Pastoral Counselor
- Winston Salem, NC
National Provider Identifier
1174814123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 193
- Practice address
- 514 S Stratford Rd
Ste 306
Winston Salem, NC 27103-1823 - Phone
- (336) 323-1616
- NPI assigned
- Apr 26, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 193 | NC | Primary |
Addresses
Primary practice location
514 S Stratford Rd
Ste 306
Winston Salem, NC 27103-1823
Mailing address
514 S Stratford Rd
Suite 306
Winston Salem, NC 27103-1823
Phone (336) 323-1616
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303776000000",
"number": "1174814123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "514 S STRATFORD RD",
"address_2": "SUITE 306",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031823",
"telephone_number": "336-323-1616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "514 S STRATFORD RD",
"address_2": "STE 306",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031823",
"telephone_number": "336-323-1616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGHERTY",
"first_name": "THOMAS",
"middle_name": "E",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-26",
"last_updated": "2011-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "NC",
"license": "193",
"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 Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.