Healthcare Provider Details

I. General information

NPI: 1134511611
Provider Name (Legal Business Name): MARY BEIRNE FLICK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY BEIRNE TAYLOR LPC

II. Dates (important events)

Enumeration Date: 02/20/2015
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 EBENEZER RD STE 225
ROCK HILL SC
29732-1119
US

IV. Provider business mailing address

414 S PINE ST
WALHALLA SC
29691-2146
US

V. Phone/Fax

Practice location:
  • Phone: 803-329-9639
  • Fax: 803-329-5830
Mailing address:
  • Phone: 864-886-4470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6563
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17909
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: