NPIMap

Organization Active NPI

Mood Treatment Center, PLLC

  • Psychiatry Physician
  • Winston Salem, NC
National Provider Identifier
1285867952
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
200100996 Issued in NC
Legal business name
MOOD TREATMENT CENTER, PLLC
Practice address
1615 Polo Rd
Winston Salem, NC 27106-3859
Phone
(336) 722-7266
Fax
(336) 201-0538
NPI assigned
Aug 28, 2009
Last updated
Oct 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
David Andrew Sack, MDNPI 1467657882
Title
Medical Director
Phone
(562) 965-3193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 200100996 NC Primary

Addresses

Primary practice location

1615 Polo Rd
Winston Salem, NC 27106-3859

Mailing address

1615 Polo Rd
Winston Salem, NC 27106-3831
Phone (336) 722-7266

Other practice location 1

104 Cambridge Plaza Dr
Winston Salem, NC 27104-3556
Phone (336) 722-7266

Other practice location 2

1901 Adams Farm Pkwy
Greensboro, NC 27407-6338
Phone (336) 722-7266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130814000785 NC Part B Supplier - Clinic/Group Practice 6103068598 Receives reassigned benefits from 14 practitioners
Practice locations: Greensboro, NC; Winston Salem, NC

National Provider Directory

National Provider Directory

Locations

379 New Market Blvd
Ste 1
Boone, NC 28607
Phone (336) 722-7286

1901 Adams Farm Pkwy
Greensboro, NC 27407
Phone 336722726623208

1403 Eastchester Dr
Ste 103
High Point, NC 27265

104 Cambridge Plaza Dr
Winston Salem, NC 27104
Phone (333) 722-7266

1615 Polo Rd
Winston Salem, NC 27106
Phone 33672272662304

713 S Marshall St
Winston Salem, NC 27101
Phone 336722726620104

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1285867952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 POLO RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063831",
            "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": "1615 POLO RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063859",
            "telephone_number": "336-722-7266",
            "fax_number": "336-201-0538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Cambridge Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271043556",
            "country_code": "US",
            "telephone_number": "336-722-7266",
            "fax_number": "336-201-0538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 Adams Farm Pkwy",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274076338",
            "country_code": "US",
            "telephone_number": "336-722-7266",
            "fax_number": "336-201-0538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOOD TREATMENT CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-28",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "SACK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "562-965-3193",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200100996",
            "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 Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.