Provider Demographics
NPI:1942455068
Name:AULD, MARY BETH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY BETH
Middle Name:
Last Name:AULD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 WIND CHIME CT.
Mailing Address - Street 2:#104
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6481
Mailing Address - Country:US
Mailing Address - Phone:919-848-9715
Mailing Address - Fax:919-848-9716
Practice Address - Street 1:185 WIND CHIME CT.
Practice Address - Street 2:#104
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6481
Practice Address - Country:US
Practice Address - Phone:919-848-9715
Practice Address - Fax:919-848-9716
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0062271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007227Medicaid