Basic Information
| Provider Information | |||||||||
| NPI: | 1215315825 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINSTEAD | ||||||||
| FirstName: | KILEY | ||||||||
| MiddleName: | ALYSS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 528 SHERWOOD FOREST PL | ||||||||
| Address2: | |||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275196353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5709540125 | ||||||||
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| Practice Location | |||||||||
| Address1: | 707 N BROADWAY | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212051832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4439231872 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2015 | ||||||||
| LastUpdateDate: | 09/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 16319 | MD | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.