Individual
MS. MARILYN K BRIMMAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPCA LCASA
Contact information
Practice address
110 S CENTER ST, MOUNT OLIVE, NC 28365-2124
(919) 635-3344
(919) 635-3388
Mailing address
PO BOX 654, MOUNT OLIVE, NC 28365-0654
(919) 223-7970
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-A-25746
NC
101YP2500X
Professional Counselor
Primary
A15194
NC
405300000X
Prevention Professional
CSAPC-20397
NC
Other
Enumeration date
10/18/2019
Last updated
10/21/2019
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