Provider Demographics
NPI:1043451685
Name:PANGLE, MARY N (PHD LPC NCC LCAS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:N
Last Name:PANGLE
Suffix:
Gender:F
Credentials:PHD LPC NCC LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 GASH LN
Mailing Address - Street 2:
Mailing Address - City:PISGAH FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:28768-7799
Mailing Address - Country:US
Mailing Address - Phone:828-884-4567
Mailing Address - Fax:
Practice Address - Street 1:59 GASH LN
Practice Address - Street 2:
Practice Address - City:PISGAH FOREST
Practice Address - State:NC
Practice Address - Zip Code:28768-7799
Practice Address - Country:US
Practice Address - Phone:828-884-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3393101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor