Healthcare Provider Details

I. General information

NPI: 1053929968
Provider Name (Legal Business Name): CARENET, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5464 MOUNTAIN VIEW RD
HAYS NC
28635-9672
US

IV. Provider business mailing address

2000 W 1ST ST STE 410
WINSTON SALEM NC
27104-4225
US

V. Phone/Fax

Practice location:
  • Phone: 363-696-5512
  • Fax: 335-566-4011
Mailing address:
  • Phone: 336-716-7339
  • Fax: 336-716-7337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ROBERT A WILLIS
Title or Position: PRESIDENT
Credential: LMFT
Phone: 336-716-7667