Provider Demographics
NPI:1972845964
Name:MAILS, MARINA (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:MAILS
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 REVOLUTION MILL DR
Mailing Address - Street 2:STUDIO 7
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5162
Mailing Address - Country:US
Mailing Address - Phone:336-202-8721
Mailing Address - Fax:
Practice Address - Street 1:1185 REVOLUTION MILL DR
Practice Address - Street 2:STUDIO 7
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5162
Practice Address - Country:US
Practice Address - Phone:336-202-8721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8183101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional