Provider Demographics
NPI:1356736102
Name:TOWNSEND, GWENDOLYN
Entity type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CENTERVIEW DR
Mailing Address - Street 2:SUITE 103 PINEHURST BUILDING
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3717
Mailing Address - Country:US
Mailing Address - Phone:336-547-8900
Mailing Address - Fax:336-547-8877
Practice Address - Street 1:2 CENTERVIEW DR
Practice Address - Street 2:SUITE 103 PINEHURST BUILDING
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3717
Practice Address - Country:US
Practice Address - Phone:336-547-8900
Practice Address - Fax:336-547-8877
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health