Individual
MARY H MASSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
806 CIRCLE DR, MONROE, NC 28112-3800
(704) 225-0584
(800) 755-9281
Mailing address
410 ROBIN DR, MONROE, NC 28112-6478
(704) 361-2612
(800) 755-9281
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3475-A
NC
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3475-A
NC SUBSTANCE ABUSE PRACTICE BOARD
NC
Enumeration date
10/02/2013
Last updated
10/02/2013
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