Provider Demographics
NPI:1811316169
Name:WINSTON, ARIEL
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:WINSTON
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 1:7904 WATERFORD LAKES DR
Mailing Address - Street 2:APT. 1037
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-7544
Mailing Address - Country:US
Mailing Address - Phone:803-556-3684
Mailing Address - Fax:
Practice Address - Street 1:408 N WHITE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2169
Practice Address - Country:US
Practice Address - Phone:704-287-8605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10289104100000X
NCP0078041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker