Provider Demographics
NPI:1346442878
Name:PRICE, GINA PRYOR (LPC, LCAS)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:PRYOR
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-4109
Mailing Address - Country:US
Mailing Address - Phone:919-734-1579
Mailing Address - Fax:919-735-1750
Practice Address - Street 1:401 N RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-4109
Practice Address - Country:US
Practice Address - Phone:919-734-1579
Practice Address - Fax:919-735-1750
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0792101YA0400X
NC4453101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health