Provider Demographics
NPI:1912497801
Name:DELLINGER, MARY BLAIR (MA, LPC-I, BCN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BLAIR
Last Name:DELLINGER
Suffix:
Gender:F
Credentials:MA, LPC-I, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:782 E BUTLER RD APT OAKS413
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-3247
Mailing Address - Country:US
Mailing Address - Phone:864-909-4250
Mailing Address - Fax:
Practice Address - Street 1:222 ADLEY WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6511
Practice Address - Country:US
Practice Address - Phone:864-909-4259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6654101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional