Provider Demographics
NPI:1346229333
Name:MAUK, DENNIS PAUL (LPC)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:PAUL
Last Name:MAUK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3000 BETHESDA PL
Mailing Address - Street 2:STE 103
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3323
Mailing Address - Country:US
Mailing Address - Phone:336-768-9768
Mailing Address - Fax:336-768-9557
Practice Address - Street 1:3000 BETHESDA PL
Practice Address - Street 2:STE 103
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3323
Practice Address - Country:US
Practice Address - Phone:336-768-9768
Practice Address - Fax:336-768-9557
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC4860101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional