Healthcare Provider Details

I. General information

NPI: 1013784875
Provider Name (Legal Business Name): PIEDMONT PARTNERS FOR MENTAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2723 HORSE PEN CREEK RD STE 105
GREENSBORO NC
27410-8390
US

IV. Provider business mailing address

2723 HORSE PEN CREEK RD STE 105
GREENSBORO NC
27410-8390
US

V. Phone/Fax

Practice location:
  • Phone: 336-265-1762
  • Fax:
Mailing address:
  • Phone: 336-265-1762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JO ANDREA HUGHES
Title or Position: MANAGING MEMBER
Credential: PA
Phone: 336-392-3413