Active NPI
Mary Willis Page, MA LPA
- Psychologist
- Salisbury, NC
National Provider Identifier
1487694303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1246
- Practice address
- 165 Mahaley Ave
Salisbury, NC 28144-2448 - Phone
- (704) 213-1099
- Fax
- (704) 919-5381
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1246 | NC | Primary |
Addresses
Primary practice location
165 Mahaley Ave
Salisbury, NC 28144-2448
Mailing address
165 Mahaley Ave
Salisbury, NC 28144-2448
Phone (704) 213-1099
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6107050 | Medicaid | NC | |
| 046G7 | Other | NC | NC BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1246 | NC | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nazareth Childrens Home | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616284800000",
"number": "1487694303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 MAHALEY AVE",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281442448",
"telephone_number": "704-213-1099",
"fax_number": "704-919-5381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 MAHALEY AVE",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281442448",
"telephone_number": "704-213-1099",
"fax_number": "704-919-5381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "MARY",
"middle_name": "WILLIS",
"name_prefix": "Mrs.",
"credential": "MA LPA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2021-03-21",
"certification_date": "2021-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "1246",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6107050",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC BCBS",
"identifier": "046G7",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.