Provider Demographics
NPI:1861687378
Name:MAHIN, GLORIA (LPC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:MAHIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAMPTON LEE CT
Mailing Address - Street 2:APT. 2 I
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 HAMPTON LEE CT
Practice Address - Street 2:APT. 2 I
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2441
Practice Address - Country:US
Practice Address - Phone:919-357-6712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6603101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional