Provider Demographics
NPI:1861577637
Name:LORTON, MARY M (LCPC)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:M
Last Name:LORTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4350 SHAWNEE MISSION PARKWAY
Mailing Address - Street 2:SUITE 252
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205
Mailing Address - Country:US
Mailing Address - Phone:913-677-9677
Mailing Address - Fax:913-677-2229
Practice Address - Street 1:4350 SHAWNEE MISSION PARKWAY
Practice Address - Street 2:SUITE 252
Practice Address - City:FAIRWAY
Practice Address - State:KS
Practice Address - Zip Code:66205
Practice Address - Country:US
Practice Address - Phone:913-677-9677
Practice Address - Fax:913-677-2229
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS224103T00000X
MOCOU000579103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist