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Individual

MRS. MARY MCLAIN GODIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPA, LPC

Contact information

Practice address
16581 US HWY 17 N, SUITE 600, HAMPSTEAD, NC 28443-7451
(910) 270-9995
(910) 270-9905
Mailing address
16581 US HWY 17 N, SUITE 600, HAMPSTEAD, NC 28443-7451
(910) 270-9995
(910) 270-9905

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2335
NC
103TC0700X
Clinical Psychologist
2335-LPA
NC
103TC0700X
Clinical Psychologist
Primary
4801-LPC
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6107097
NC
Enumeration date
12/16/2005
Last updated
08/01/2012
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