Provider Demographics
NPI:1982826251
Name:MAYFIELD, MARY FLEURY (LPC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:FLEURY
Last Name:MAYFIELD
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:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:MILLWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:22646
Mailing Address - Country:US
Mailing Address - Phone:540-837-1384
Mailing Address - Fax:
Practice Address - Street 1:NORTHWESTERN COMMUNITY SERVICES
Practice Address - Street 2:23 W. MAIN STREET
Practice Address - City:LURAY
Practice Address - State:VA
Practice Address - Zip Code:22835
Practice Address - Country:US
Practice Address - Phone:540-743-4548
Practice Address - Fax:540-743-6067
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004107101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional