Central Piedmont Access II

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C001547 Issued in NC

Legal business name

CENTRAL PIEDMONT ACCESS II

Practice address

1920 W 1St St
Floor 5
Winston Salem, NC 27104-4220

Phone

(336) 716-5654

Fax

(336) 716-2683

NPI assigned

Feb 12, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jim Graham

Title

Executive Director

Phone

(336) 716-5654

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326180118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15046",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271130046",
            "telephone_number": "336-716-5654",
            "fax_number": "336-716-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 W 1ST ST",
            "address_2": "FLOOR 5",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044220",
            "telephone_number": "336-716-5654",
            "fax_number": "336-716-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PIEDMONT ACCESS II",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-716-5654",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C001547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005896",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anthony Samuel Ceraulo, D.O.
• Jennifer Luzia Cerny, MS, NP-C

• 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 Aug 22, 2020; 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.