Provider Demographics
NPI:1144476169
Name:FROST, MARY ANN (LMHC)
Entity type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29605 US 19 N
Mailing Address - Street 2:SUITE 330
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-1537
Mailing Address - Country:US
Mailing Address - Phone:727-741-8096
Mailing Address - Fax:727-938-9921
Practice Address - Street 1:29605 US 19 N
Practice Address - Street 2:SUITE 330
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-1537
Practice Address - Country:US
Practice Address - Phone:727-741-8096
Practice Address - Fax:727-938-9921
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health