Provider Demographics
NPI:1093450462
Name:CLERVOIX-FRANK, MAUDELINE (LCMHCA, LCASA)
Entity type:Individual
Prefix:
First Name:MAUDELINE
Middle Name:
Last Name:CLERVOIX-FRANK
Suffix:
Gender:F
Credentials:LCMHCA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8620 ENGLISH SADDLE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-6069
Mailing Address - Country:US
Mailing Address - Phone:929-270-2137
Mailing Address - Fax:910-824-7593
Practice Address - Street 1:8620 ENGLISH SADDLE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-6069
Practice Address - Country:US
Practice Address - Phone:929-270-2137
Practice Address - Fax:910-824-7593
Is Sole Proprietor?:No
Enumeration Date:2022-04-30
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18506101YM0800X
NCLCAS-28787101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)