Kawanna Teresa Woods-Willis

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P015096 Issued in NC

Practice address

7670 N Point CT
Winston Salem, NC 27106-3336

Phone

(336) 724-1412

Fax

(336) 724-1464

NPI assigned

Oct 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1487906327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7670 N POINT CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063336",
            "telephone_number": "336-724-1412",
            "fax_number": "336-724-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7670 N POINT CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063336",
            "telephone_number": "336-724-1412",
            "fax_number": "336-724-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS-WILLIS",
        "first_name": "KAWANNA",
        "middle_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P015096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Woodhead
• John Jay Woodmansee, PHD
• Rachel Katherine Woodruff, M.D.
• Ralph Dutton Woodruff, MD
• Tyler Woodrum, MD
• David K Woods, D.M.D
• Tiffany Blake Woods, LCMHCA
• Abigail Woodson, RBT
• Faraji Woodson
• Lakisha Kay Woodson, LCSWA

• 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 31, 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.