Salem Psychiatric Assoc

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

20823 Issued in NC

Legal business name

SALEM PSYCHIATRIC ASSOC

Practice address

175 Kimel Park Dr
Suite 115
Winston Salem, NC 27103-6951

Phone

(336) 659-9440

Fax

(336) 659-9845

NPI assigned

Feb 19, 2007

Organization subpart

No

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

Authorized official

Name

Roger McCauley, MD

Title

Owner

Phone

(336) 659-9440

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Eleanore Jeanine Chadwell, LPC

  • Counselor
  • Winston Salem, NC
  • NPI 1508852856
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396889549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 KIMEL PARK DR",
            "address_2": "SUITE 115",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036951",
            "telephone_number": "336-659-9440",
            "fax_number": "336-659-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 KIMEL PARK DR",
            "address_2": "SUITE 115",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036951",
            "telephone_number": "336-659-9440",
            "fax_number": "336-659-9845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM PSYCHIATRIC ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCAULEY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-659-9440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NC",
            "license": "20823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02594",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902594",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salem Neurological Center, P.a.
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• Salem Plastic Surgery Inc
• Salem Rheumatology PA
• Salem Speech & Language Services, Inc.
• Salem Speech, PLLC
• Salem Surgical Assocs PA
• Salem Terrace Alf Opco LLC

• Cognitive & Behavioral Psychologist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Cognitive & Behavioral Psychologist 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.