Provider Demographics
NPI:1407254287
Name:ESQUIVEL, MARY CHRISTIE (LCSWA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CHRISTIE
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 CAROLINA PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-8432
Mailing Address - Country:US
Mailing Address - Phone:361-446-0378
Mailing Address - Fax:
Practice Address - Street 1:1401 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-5502
Practice Address - Country:US
Practice Address - Phone:252-636-3341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0093541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical