Basic Information
| Provider Information | |||||||||
| NPI: | 1205032430 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HENDRIX | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | MA, NCC,LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36 14TH AVE NE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283284313 | ||||||||
| FaxNumber: | 8283284820 | ||||||||
| Practice Location | |||||||||
| Address1: | 36 14TH AVE NE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283284313 | ||||||||
| FaxNumber: | 8283284820 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 0500 | NC | Y | Behavioral Health & Social Service Providers | Counselor |
ID Information
| ID | Type | State | Issuer | Description | 41528 | 01 | NC | BCBS PROVIDER NUMBER | OTHER |