Healthcare Provider Details

I. General information

NPI: 1063090058
Provider Name (Legal Business Name): PEOPLE'S ACCESS OF NORTH CAROLINA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8011 N POINT BLVD STE B
WINSTON SALEM NC
27106-3244
US

IV. Provider business mailing address

8011 N POINT BLVD STE B
WINSTON SALEM NC
27106-3244
US

V. Phone/Fax

Practice location:
  • Phone: 336-355-8666
  • Fax:
Mailing address:
  • Phone: 336-355-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DAVIDA LENNON
Title or Position: OWNER
Credential: LCSWA
Phone: 336-355-8666