Provider Demographics
NPI:1235220567
Name:WINSTED, GREGORY PHILIP (MS)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:PHILIP
Last Name:WINSTED
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1473 BIG LEAF LOOP
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-9018
Mailing Address - Country:US
Mailing Address - Phone:919-363-7437
Mailing Address - Fax:
Practice Address - Street 1:1473 BIG LEAF LOOP
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-9018
Practice Address - Country:US
Practice Address - Phone:919-363-7437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC942106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6105042Medicaid