Provider Demographics
NPI:1912497801
Name:DELLINGER, MARY BLAIR (LPC, BCN, QEEG-DL)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:BLAIR
Last Name:DELLINGER
Suffix:
Gender:F
Credentials:LPC, BCN, QEEG-DL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CAMBRIA CT
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2165
Mailing Address - Country:US
Mailing Address - Phone:864-909-4250
Mailing Address - Fax:
Practice Address - Street 1:222 ADLEY WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6511
Practice Address - Country:US
Practice Address - Phone:864-909-4259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional