Provider Demographics
NPI:1376734020
Name:HUSTON, NATALIE R (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:R
Last Name:HUSTON
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 SAM NEWELL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4519
Mailing Address - Country:US
Mailing Address - Phone:980-253-9841
Mailing Address - Fax:
Practice Address - Street 1:1126 SAM NEWELL RD
Practice Address - Street 2:SUITE A
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4519
Practice Address - Country:US
Practice Address - Phone:980-253-9841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6477101YP2500X
PAPC004299101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional