Provider Demographics
NPI:1861438277
Name:HORAN, MARIA LOUISE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LOUISE
Last Name:HORAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 868
Mailing Address - Street 2:
Mailing Address - City:CARRABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:32322-0868
Mailing Address - Country:US
Mailing Address - Phone:850-697-2533
Mailing Address - Fax:850-697-2122
Practice Address - Street 1:406 SE AVENUE B
Practice Address - Street 2:
Practice Address - City:CARRABELLE
Practice Address - State:FL
Practice Address - Zip Code:32322-6086
Practice Address - Country:US
Practice Address - Phone:850-697-2122
Practice Address - Fax:850-697-2122
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ5193Medicare ID - Type Unspecified