Individual
ELIZABETH MARY COSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
200 E MAIN ST, SUITE 201, CLAYTON, NC 27520-2472
(919) 523-2110
(919) 465-3462
Mailing address
309 DANSK CT, CARY, NC 27511-3195
(919) 523-2110
(919) 465-3462
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3495
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102773
—
NC
Enumeration date
07/11/2006
Last updated
04/10/2012
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