Healthcare Provider Details

I. General information

NPI: 1306036470
Provider Name (Legal Business Name): LATRINA DEVONNE WINFORD LPCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 S MARTIN LUTHER KING JR DR STE 15
WINSTON SALEM NC
27107-1371
US

IV. Provider business mailing address

1922 S MARTIN LUTHER KING JR DR STE 15
WINSTON SALEM NC
27107-1371
US

V. Phone/Fax

Practice location:
  • Phone: 336-577-6652
  • Fax: 336-464-2071
Mailing address:
  • Phone: 336-577-6652
  • Fax: 888-320-8093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6715
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6715
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: