Healthcare Provider Details

I. General information

NPI: 1982249116
Provider Name (Legal Business Name): CARENET, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 WHITE PLAINS RD
ROARING RIVER NC
28669-9200
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 336-696-4628
  • Fax:
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: BRYAN G. HATCHER
Title or Position: PRESIDENT
Credential: LCSW
Phone: 336-716-0858