Provider Demographics
NPI:1588248991
Name:MAYER, KATHY M (LCMHCA)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:M
Last Name:MAYER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 LEGION RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2373
Mailing Address - Country:US
Mailing Address - Phone:919-448-3315
Mailing Address - Fax:919-832-5446
Practice Address - Street 1:5121 HOLLYRIDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3111
Practice Address - Country:US
Practice Address - Phone:919-448-3315
Practice Address - Fax:919-832-5446
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health