Provider Demographics
NPI:1992182448
Name:PREVOST, MARGARET FLAHERTY (LPC, LCMHC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:FLAHERTY
Last Name:PREVOST
Suffix:
Gender:F
Credentials:LPC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 EVERGREEN LN
Mailing Address - Street 2:
Mailing Address - City:PINE KNOLL SHORES
Mailing Address - State:NC
Mailing Address - Zip Code:28512-0179
Mailing Address - Country:US
Mailing Address - Phone:571-228-5083
Mailing Address - Fax:
Practice Address - Street 1:106 EVERGREEN LN
Practice Address - Street 2:
Practice Address - City:PINE KNOLL SHORES
Practice Address - State:NC
Practice Address - Zip Code:28512-0179
Practice Address - Country:US
Practice Address - Phone:571-228-5083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional