Walston, Mary

Walston, Mary is an sole proprietor health care provider with primary practice located at 7718 Magma Dr , Fayetteville NC 28311-7426. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Walston, Mary can be contacted via phone (336) 339-2865.

Contact Information

Primary practice address
7718 Magma Dr Fayetteville NC 28311-7426
Phone: (336) 339-2865
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X North Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 10538 North Carolina

Profile Details

NPI number 1497093975
LBN Legal business name Walston, Mary
Credentials LCMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 17th, 2013
Last updated Oct 27th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497093975 NPPES
North Carolina MEDICAID 1497093975

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