Basic Information
| Provider Information | |||||||||
| NPI: | 1760948814 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GINGHER | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | DEE | ||||||||
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| Credential: | LPCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2410 ELIZABETH AVE | ||||||||
| Address2: | |||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271033527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366023305 | ||||||||
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| Practice Location | |||||||||
| Address1: | 820 GRIMES BLVD | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272927640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662727826 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2019 | ||||||||
| LastUpdateDate: | 02/13/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | A14295 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.