Virginia Wilson Jeffers, LCSW LCAS
Individual provider Active NPI Clinical Social Worker · Winston Salem, NC
NPI 1780880286 · NPPES record last updated Feb 25, 2019
Key facts
- NPI
- 1780880286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C004243 (NC)
- Practice address
- 725 Highland Ave
Winston Salem, NC 27101-4206 - Phone
- (336) 607-8523
- Fax
- (336) 733-0913
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C004243 | NC | MD | Clinical Social Worker |
| 1337 | NC | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1337 | NC | |
| Clinical Social Worker | 1041C0700X | C004243 | NC | Yes |
Addresses
Primary practice location
725 Highland Ave
Winston Salem, NC 27101-4206
Mailing address
101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781
Phone (888) 849-7379
Other practice location 1
101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781
Phone (888) 849-7379
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1434V | Other | NC | BCBSNC |
| 6003636 | Medicaid | NC | |
| 11915020 | Other | NC | CAQH |
Other providers in Winston Salem, NC
- Usha Jayagurunathan
- JC&G Group Homes, LLC
- JCM Advocate Development and Human Services
- JCSW Enterprises, LLC
- Isabel Cristina Jean
- Carmen Ni'Asia Jefferson
- Jeffrey C. Zackeru, DMD, PLLC
- Jeffrey J. Tibbs, DDS, PA
- Calvert Jeffries
- Sonya D H Jeffries
All providers in Winston Salem, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.