Provider Demographics
NPI:1730906181
Name:MAHAFFEY, MARY ELLEN (LPC-ASSOCIATE)
Entity type:Individual
Prefix:MRS
First Name:MARY ELLEN
Middle Name:
Last Name:MAHAFFEY
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:MISS
Other - First Name:MARY ELLEN
Other - Middle Name:
Other - Last Name:SHUFFLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 N. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-3816
Mailing Address - Country:US
Mailing Address - Phone:817-202-3976
Mailing Address - Fax:817-202-3978
Practice Address - Street 1:805 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-3816
Practice Address - Country:US
Practice Address - Phone:817-202-3976
Practice Address - Fax:817-202-3978
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health