Organization Active NPI

Wide Spaces PLLC

  • Clinical Social Worker
  • Winston Salem, NC
National Provider Identifier
1316741077
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WIDE SPACES PLLC
Practice address
221 E Sprague St
Winston Salem, NC 27127-3013
Phone
(336) 496-1621
NPI assigned
Apr 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Authorized official

Name
Tamara Payden Travers McLaughlin, MSW, LCSWANPI 1780427849
Title
Owner/Clinician
Phone
(336) 473-1575

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

221 E Sprague St
Winston Salem, NC 27127-3013

Mailing address

221 E Sprague St
Winston Salem, NC 27127-3013

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1316741077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E SPRAGUE ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E SPRAGUE ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273013",
            "telephone_number": "336-496-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIDE SPACES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "MCLAUGHLIN",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "PAYDEN TRAVERS",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "336-473-1575",
        "authorized_official_credential": "MSW, LCSWA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 2, 2025; 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.