Provider Demographics
NPI:1194800458
Name:HARRISON, MARGARET HUNTLEY (LPC LMFT)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:HUNTLEY
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LPC LMFT
Other - Prefix:MRS
Other - First Name:MARGARET
Other - Middle Name:HUNTLEY
Other - Last Name:MOSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAED COUNSELING
Mailing Address - Street 1:125 ASHLEY BROOK SQUARE
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103
Mailing Address - Country:US
Mailing Address - Phone:336-765-6577
Mailing Address - Fax:336-765-7656
Practice Address - Street 1:125 ASHLEY BROOK SQUARE
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-765-6577
Practice Address - Fax:336-765-7656
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3768101YP2500X
NC935106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC133VAOtherBCBS
NC6102731Medicaid