Provider Demographics
NPI:1245603323
Name:WINSTON, COREY CHRISTOPHER (LCSW,LCASA,CCSOTS)
Entity Type:Individual
Prefix:MR
First Name:COREY
Middle Name:CHRISTOPHER
Last Name:WINSTON
Suffix:
Gender:M
Credentials:LCSW,LCASA,CCSOTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 GODWIN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3149
Mailing Address - Country:US
Mailing Address - Phone:910-739-8849
Mailing Address - Fax:910-739-8698
Practice Address - Street 1:2003 GODWIN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3149
Practice Address - Country:US
Practice Address - Phone:910-739-8849
Practice Address - Fax:910-739-8698
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0109811041C0700X
NCLCAS-21962101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)