Healthcare Provider Details

I. General information

NPI: 1306758289
Provider Name (Legal Business Name): NOVA DIA COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 S CHERRY ST
WINSTON SALEM NC
27101-5284
US

IV. Provider business mailing address

1716 SILVER RUN CT
WINSTON SALEM NC
27127-5767
US

V. Phone/Fax

Practice location:
  • Phone: 336-464-7711
  • Fax:
Mailing address:
  • Phone: 336-596-3739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMBER GARCIA
Title or Position: PRACTICE OWNER AND PSYCHOTHERAPIST
Credential: LCMHC
Phone: 336-464-7711