Angela De Varona, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

1702 S Hawthorne Rd
Winston Salem, NC 27103-4016

Phone

(336) 659-8301

Fax

(336) 659-9361

NPI assigned

Aug 23, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Amy D. Foster

  • Community/Behavioral Health Agency
  • Clemmons, NC
  • NPI 1487957783
  NPD (past)
• Tri-Care, PA

  • Clinical Child & Adolescent Psychologist
  • Winston Salem, NC
  • NPI 1558477257

  Clinical Child & Adolescent

  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1689780322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034016",
            "telephone_number": "336-659-8301",
            "fax_number": "336-659-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034016",
            "telephone_number": "336-659-8301",
            "fax_number": "336-659-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VARONA",
        "first_name": "ANGELA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSPROVIDER#",
            "identifier": "045U0",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC PSYCHOLOGY LICENSE#",
            "identifier": "1897",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DC Performance LLC
• Alice De Assis Betti
• Chasity De Bodisco, M.A. LCMHC, LMFT
• Andrew Manuel De Jesus, MD
• Frances Michelle De la Camara, MD
• Michelle Elizabeth De Witt, M.D.
• Anton Jordan De Witte, MD
• Deakle Family Counseling
• Courtney Deakle, MA, LCMHC-A
• Brandon Deal, PHARMD

• All providers in Winston Salem, NC
• Clinical Child & Adolescent Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.