Provider Demographics
NPI:1003993460
Name:MAYFIELD, ELEANOR M (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELEANOR
Middle Name:M
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 WOODSTONE DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4746
Mailing Address - Country:US
Mailing Address - Phone:856-627-9053
Mailing Address - Fax:
Practice Address - Street 1:199 6TH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-9749
Practice Address - Country:US
Practice Address - Phone:856-235-8007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00033600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health