Individual provider Active NPI

Mary J Strother, L.P.C.

  • Professional Counselor
  • Dothan, AL
National Provider Identifier
1023397379
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2963 Issued in AL
Practice address
101 Medical Dr
Dothan, AL 36303-6903
Phone
(334) 702-7222
Fax
(334) 712-0972
NPI assigned
Aug 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2963 AL Primary

Addresses

Primary practice location

101 Medical Dr
Dothan, AL 36303-6903

Mailing address

101 Medical Dr
Dothan, AL 36303-6903
Phone (334) 702-7222

Other identifiers 1

IdentifierTypeStateIssuer
129599MedicaidAL

Other names 1

  • Mary J Keeter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829004352 AL Practitioner - Mental Health Counselor 7315486669 Practice locations: Dothan, AL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 Medical Dr
Dothan, AL 36303-6903
Phone (334) 702-7222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2963ALMDPeriodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1023397379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MEDICAL DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363036903",
            "telephone_number": "334-702-7222",
            "fax_number": "334-712-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEDICAL DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363036903",
            "telephone_number": "334-702-7222",
            "fax_number": "334-712-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROTHER",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-04",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "2963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129599",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KEETER",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.