DR. GUSTAVO RAFAEL GRODNITZKY


Address: 736 Mitch Dr, Winston Salem, NC 27104-5126
Phone: 3366598058

DR. GUSTAVO RAFAEL GRODNITZKY (NPI# 1043549900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043549900
Entity Type Individual
Full Name DR. GUSTAVO RAFAEL GRODNITZKY
Credential PH.D.
Practice Address 736 Mitch Dr
Winston Salem
NC 27104-5126
Practice Telephone 3366598058
Mailing Telephone 3366598058
Enumeration Date 2009-12-23
Last Update Date 2010-01-05
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 2810 NC Behavioral Health & Social Service Providers

Office Location

Street Address 736 MITCH DR
City WINSTON SALEM
State NC
Zip Code 27104-5126

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1447807664 Cameron Grant Ford Psychologist 614 Country Club Road, Winston-salem, NC 27104 2019-08-22
1104310374 Novant Medical Group, Inc. Internal Medicine 4937 Old Country Club Rd, Winston Salem, NC 27104 2018-06-20
1982100509 Dillon James Magalski Student in an Organized Health Care Education/Training Program Piedmont Plaza 1, 1920 West First Street, Wake Forest Baptist Medical Center, Winston-salem, NC 27104 2018-04-03
1891290144 Breann M Poling Student in an Organized Health Care Education/Training Program Wake Forest Baptist Medical Center, Department Of, Family Medicine Piedmont Plaza I 1920 West First Street, Winston Salem, NC 27104 2018-03-28
1689178600 Christopher Vasil Student in an Organized Health Care Education/Training Program Piedmont Plaza I, 1920 West First Street, Department of Family Medicine, Winston Salem, NC 27104 2018-03-23
1407379126 April Lynn Lowe Registered Nurse 940 N Peace Haven Rd, Winstonsalem, NC 27104 2017-07-25
1164950804 Donald Joyce Student in an Organized Health Care Education/Training Program 1920 West First St, Piedmont Plaza I Building, 3rd Floor, Winston-salem, NC 27104 2017-05-25
1255867289 Benjamin Hansen Pharmacist 2150 Country Club Rd Ste 300, Winston Salem, NC 27104 2017-05-11
1770020976 Jane Reed Physical Medicine & Rehabilitation 2627 E Greenbrier Road, Winston Salem, NC 27104 2017-01-25
1053728261 Ashraf Alsaedi Pharmacist 1659 Stratford Rd Nw, Winston Salem, NC 27104 2014-07-20
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477939213 The Epilepsy Institute of Nc Psychologist 1311 Westbrook Plaza Dr Ste 100, Winston Salem, NC 27103-1327 2015-08-04
1558779785 Tara Laymon Psychologist 4264 Saddlewood Forest Dr, Winston Salem, NC 27106-3576 2014-07-31
1780901926 Howard Thomas Bosworth Psychologist 1304 Ashley Square, Winston Salem, NC 27103 2010-04-28
1548470776 Dianne Mitchell, Ph.d., Pllc Psychologist 121 Reynolda Vlg, Suite G, Winston Salem, NC 27106-5126 2007-05-23
1801003371 Pamela D. Corbett Psychologist 3560 Buena Vista Rd, Winston Salem, NC 27106-5736 2007-05-16
1295870194 Embrenche LLC Psychologist 1001 S Marshall St Ste 262, 1001 S Marshall Street Suite 262, Winston Salem, NC 27101-5852 2007-02-20
1154406411 Vicky Gaye Surratt Psychologist 125 Ashleybrook Square, Winston Salem, NC 27103 2006-10-26
1659306488 Jeffrey Alan Smith Psychologist 3455 Polo Rd, Suite 106, Winston Salem, NC 27106-4828 2006-07-11
1609800895 David S. Bathory Psychologist 2575 Woodberry Dr, Winston Salem, NC 27106-4622 2006-07-11
1821037144 William Maxwell Acree Psychologist 190 Kimel Park Dr Ste 121, Winston Salem, NC 27103-6946 2006-06-05
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City WINSTON SALEM
Zip Code 27104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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