Provider Demographics
NPI:1861488850
Name:AREY, MARISSA PEREZ (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:PEREZ
Last Name:AREY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-0425
Mailing Address - Country:US
Mailing Address - Phone:910-791-9625
Mailing Address - Fax:
Practice Address - Street 1:1911 S 17TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6662
Practice Address - Country:US
Practice Address - Phone:910-791-9625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4476101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102679Medicaid
NC142FNOtherBCBS OF NC