Individual
MARY NEBERGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
513 MADISON AVE, COVINGTON, KY 41011-1505
(859) 578-3200
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 578-3204
(859) 578-3273
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
248448
KY
101YP2500X
Professional Counselor
248448
KY
221700000X
Art Therapist
260363
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610661458
TAX ID
KY
Enumeration date
11/15/2016
Last updated
01/26/2024
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