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General NPI Number Information
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NPI Number | 1043300098
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Entity Type | Individual
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Provider Name | MARY H. LIVINGSTON M.ED., LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 109 BRADFORD AVE
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-5401
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Country | US
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Telephone | 910-323-0601
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Fax | 910-222-6547
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Provider Business Mailing Address
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Address Line | 202 BETHUNE ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-4704
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Country | US
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Telephone | 910-484-6383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC 2815
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | NCC 38985
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License Number State | NC
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