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Individual

MS. KATHY DODGE MANSFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC LCAS CCS

Contact information

Practice address
2807 NEUSE BLVD, STE 5, NEW BERN, NC 28562-2815
(252) 636-0112
(252) 634-9778
Mailing address
2807 NEUSE BLVD, STE 5, NEW BERN, NC 28562-2815
(252) 636-0112
(252) 634-9778

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC1030
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS28
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14309
BCBS
NC
01
1572
CBHA
NC
01
161958
VALUE OPTIONS
NC
01
304557
MHN
NC
05
6102019
NC
Enumeration date
01/24/2006
Last updated
10/19/2010
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