Provider Demographics
NPI:1376689315
Name:HEBERT, MARY LADD (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:LADD
Last Name:HEBERT
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Gender:F
Credentials:LCSW
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Mailing Address - Street 1:2990 BETHESDA PL
Mailing Address - Street 2:602-A
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3318
Mailing Address - Country:US
Mailing Address - Phone:336-768-8281
Mailing Address - Fax:336-768-5685
Practice Address - Street 1:2990 BETHESDA PL
Practice Address - Street 2:602-A
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3318
Practice Address - Country:US
Practice Address - Phone:336-768-8281
Practice Address - Fax:336-768-5685
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCC0007061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical