Provider Demographics
NPI:1699346197
Name:PEGRAM, EMILY ELIZABETH MAGGARD (LCMHC-A NCC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH MAGGARD
Last Name:PEGRAM
Suffix:
Gender:F
Credentials:LCMHC-A NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 NEW LEICESTER HWY UNIT A
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-1929
Mailing Address - Country:US
Mailing Address - Phone:850-723-9213
Mailing Address - Fax:
Practice Address - Street 1:41 CLAYTON ST # 300
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2423
Practice Address - Country:US
Practice Address - Phone:828-515-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16647101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health