Healthcare Provider Details

I. General information

NPI: 1639779655
Provider Name (Legal Business Name): WARFAIR COUNSELING, CONSULTING, & SUPERVISION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 OLD MILL CIR STE D
WINSTON SALEM NC
27103-2977
US

IV. Provider business mailing address

1400 OLD MILL CIR STE D
WINSTON SALEM NC
27103-2977
US

V. Phone/Fax

Practice location:
  • Phone: 336-422-6159
  • Fax:
Mailing address:
  • Phone: 336-422-6159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. LATASHA YVONNE HICKS BECTON
Title or Position: OWNER
Credential: PHD, LCMHC, LCAS, CC
Phone: 336-422-6159