Provider Demographics
NPI:1144557265
Name:MCDERMOTT, MARY ELIZABETH (LMHC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:MCDERMOTT
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 1:5245 OFFICE PARK BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-3444
Mailing Address - Country:US
Mailing Address - Phone:941-751-7545
Mailing Address - Fax:941-755-2514
Practice Address - Street 1:5245 OFFICE PARK BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-3444
Practice Address - Country:US
Practice Address - Phone:941-751-7545
Practice Address - Fax:941-755-2514
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8321101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health