Provider Demographics
NPI:1700892619
Name:VERGA, JOSEPH THOMAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:VERGA
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:8025 N POINT BLVD
Mailing Address - Street 2:SUITE 231
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3262
Mailing Address - Country:US
Mailing Address - Phone:336-896-0065
Mailing Address - Fax:336-896-0710
Practice Address - Street 1:8025 N POINT BLVD
Practice Address - Street 2:SUITE 231
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3262
Practice Address - Country:US
Practice Address - Phone:336-896-0065
Practice Address - Fax:336-896-0710
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1001103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04839OtherBCBS
NY04839OtherBCBS