Provider Demographics
NPI:1326278201
Name:OPEN DOORS COUNSELING & WELLNESS INC
Entity Type:Organization
Organization Name:OPEN DOORS COUNSELING & WELLNESS INC
Other - Org Name:WINFORD BROWN-RAMSEUR & ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATRINA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WINFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:336-577-6652
Mailing Address - Street 1:2720 GEORGETOWN DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-5473
Mailing Address - Country:US
Mailing Address - Phone:336-896-9771
Mailing Address - Fax:336-464-2071
Practice Address - Street 1:2720 GEORGETOWN DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5473
Practice Address - Country:US
Practice Address - Phone:336-896-9771
Practice Address - Fax:336-464-2071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-25
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC458101YA0400X
NC6715101YM0800X
NC94002662084P0800X
251S00000X
NCMHL-034-265251S00000X
NC001001278363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917320Medicaid
NC7212654Medicaid
NC8302967Medicaid
NC6006903Medicaid