MEDICARE: MRS. MARY MORGAN STARLING LCMHCA

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	A15584	NC

General Provider Information

NPI Number	:	1013541473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY MORGAN STARLING LCMHCA

Provider Business Mailing Address
First Line	:	1743 ROSEBAY CT SW
Second Line	:
City	:	OCEAN ISLE BEACH
State	:	NC
Zip	:	28469-5772
Country	:	US
Telephone Number	:	910-471-5750
Fax Number	:

Provider Business Practice Location Address
First Line	:	9970 BEACH DR
Second Line	:
City	:	CALABASH
State	:	NC
Zip	:	28467-2741
Country	:	US
Telephone Number	:	910-471-5750
Fax Number	:

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

Provider Enumeration Date	:	02/25/2020
Last Update Date	:	10/10/2022

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