The Bridge at Brookstown

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

MHL034236 Issued in NC

Legal business name

THE BRIDGE AT BROOKSTOWN

Practice address

235 S Cherry St
Winston Salem, NC 27101-5230

Phone

(336) 725-8646

Fax

(336) 725-8654

NPI assigned

Jan 26, 2009

Last updated

Jan 26, 2009By 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

Dr. Barry N Williams, M.D.

Title

Medical Director

Phone

(336) 725-8646

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232928000000",
    "number": "1417195785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 S CHERRY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015230",
            "telephone_number": "336-725-8646",
            "fax_number": "336-725-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 S CHERRY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015230",
            "telephone_number": "336-725-8646",
            "fax_number": "336-725-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRIDGE AT BROOKSTOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-26",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "336-725-8646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "MHL034236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.