MEDICARE: MARY BEIRNE FLICK LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6563	SC
2	101YM0800X	Mental Health Counselor	17909	NC

General Provider Information

NPI Number	:	1134511611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY BEIRNE FLICK LPC

Provider Business Mailing Address
First Line	:	414 S PINE ST
Second Line	:
City	:	WALHALLA
State	:	SC
Zip	:	29691-2146
Country	:	US
Telephone Number	:	864-886-4470
Fax Number	:

Provider Business Practice Location Address
First Line	:	1721 EBENEZER RD STE 225
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-1119
Country	:	US
Telephone Number	:	803-329-9639
Fax Number	:	803-329-5830

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2015
Last Update Date	:	06/15/2026

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Directions to “ MARY BEIRNE FLICK LPC” Practice Location

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