Provider Demographics
NPI:1710139100
Name:WINEK, JON L (PHD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:L
Last Name:WINEK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 UNIVERSITY HALL DRIVE
Mailing Address - Street 2:ROOM 120
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28608-2102
Mailing Address - Country:US
Mailing Address - Phone:828-262-7675
Mailing Address - Fax:828-262-6766
Practice Address - Street 1:400 UNIVERSITY HALL DRIVE
Practice Address - Street 2:ROOM 120
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28608-2102
Practice Address - Country:US
Practice Address - Phone:828-262-7675
Practice Address - Fax:828-262-6766
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC605OtherMARRIAGE & FAMILY THERAPIST
NC3515OtherLICENSED PROFESSIONAL COUNSELOR