Healthcare Provider Details

I. General information

NPI: 1922938091
Provider Name (Legal Business Name): CHARITY PATTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

2450 NORTHWICK DR APT 208
WINSTON SALEM NC
27103-6492
US

V. Phone/Fax

Practice location:
  • Phone: 336-893-7742
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP023155
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: