Provider Demographics
NPI:1881175438
Name:BIGELOW, MARY GRACE (LCMHC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:GRACE
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 MERRIMON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1222
Mailing Address - Country:US
Mailing Address - Phone:828-209-8963
Mailing Address - Fax:
Practice Address - Street 1:346 MERRIMON AVE STE C
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1222
Practice Address - Country:US
Practice Address - Phone:828-209-8963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14095101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health