Healthcare Provider Details

I. General information

NPI: 1598046302
Provider Name (Legal Business Name): BRAULIO M VELEZ ACEVEDO PHD, MSW CCRET, CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 04/06/2025
Certification Date: 04/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3684 EMMA AVE
WINSTON SALEM NC
27127
US

IV. Provider business mailing address

3684 EMMA AVE
WINSTON SALEM NC
27127-6024
US

V. Phone/Fax

Practice location:
  • Phone: 704-579-9565
  • Fax:
Mailing address:
  • Phone: 704-579-9565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: