Provider Demographics
NPI:1033455506
Name:WINNER, ADELMAR DE LOS ANGELES (LCSW)
Entity Type:Individual
Prefix:
First Name:ADELMAR
Middle Name:DE LOS ANGELES
Last Name:WINNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ADELMAR
Other - Middle Name:DE LOS ANGELES
Other - Last Name:FARNATARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3801 LAKE BOONE TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-2994
Mailing Address - Country:US
Mailing Address - Phone:919-865-8788
Mailing Address - Fax:
Practice Address - Street 1:3801 LAKE BOONE TRL STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-2994
Practice Address - Country:US
Practice Address - Phone:919-865-8788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0080261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical