Healthcare Provider Details

I. General information

NPI: 1851225361
Provider Name (Legal Business Name): SHANON ELAINE GREIG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1540 WESTBROOK PLAZA DR
WINSTON SALEM NC
27103-1331
US

IV. Provider business mailing address

1540 WESTBROOK PLAZA DR
WINSTON SALEM NC
27103-1331
US

V. Phone/Fax

Practice location:
  • Phone: 336-803-0223
  • Fax:
Mailing address:
  • Phone: 336-803-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP023740
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: