Provider Demographics
NPI:1962551317
Name:DERKS DELLINGER, MARY E (MS, NCC, LPC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:E
Last Name:DERKS DELLINGER
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:E
Other - Last Name:DERKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 GRIFFIN ST
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-8630
Mailing Address - Country:US
Mailing Address - Phone:828-736-4402
Mailing Address - Fax:828-586-2099
Practice Address - Street 1:15 GRIFFIN ST
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-8630
Practice Address - Country:US
Practice Address - Phone:828-736-4402
Practice Address - Fax:828-586-2099
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7082101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional