Healthcare Provider Details

I. General information

NPI: 1386650851
Provider Name (Legal Business Name): DISABILITY ADVOCACY AND INFORMATION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8064 N POINT BLVD SUITE 102
WINSTON SALEM NC
27106-3235
US

IV. Provider business mailing address

8064 N POINT BLVD SUITE 102
WINSTON SALEM NC
27106-3235
US

V. Phone/Fax

Practice location:
  • Phone: 336-896-0900
  • Fax: 336-896-0901
Mailing address:
  • Phone: 336-896-0900
  • Fax: 336-896-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9900009
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SUSAN A REEVES
Title or Position: PRESIDENT
Credential:
Phone: 336-896-0900