Healthcare Provider Details

I. General information

NPI: 1407651235
Provider Name (Legal Business Name): REVOLUTIONARY THINKING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 BRIDGE ST STE 113
WINSTON SALEM NC
27101-1198
US

IV. Provider business mailing address

915 BRIDGE ST STE 113 PMB 115
WINSTON SALEM NC
27101-1198
US

V. Phone/Fax

Practice location:
  • Phone: 336-281-5597
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE WRIGHT
Title or Position: OWNER
Credential: LCMHC
Phone: 336-281-5597