Provider Demographics
NPI:1982193496
Name:MCGILVARY, DOROTHY JEAN (LMFTA, LCAS-A)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:JEAN
Last Name:MCGILVARY
Suffix:
Gender:F
Credentials:LMFTA, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 WATER ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7540
Mailing Address - Country:US
Mailing Address - Phone:919-373-8712
Mailing Address - Fax:919-373-8712
Practice Address - Street 1:8404 SIX FORKS RD STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3073
Practice Address - Country:US
Practice Address - Phone:919-467-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12081A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist