Provider Demographics
NPI:1124389127
Name:CHRISTIE, MARIETTA CLARK (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:MARIETTA
Middle Name:CLARK
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8313
Mailing Address - Country:US
Mailing Address - Phone:508-879-2250
Mailing Address - Fax:
Practice Address - Street 1:356 BILTMORE AVE STE 200
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801
Practice Address - Country:US
Practice Address - Phone:828-254-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional