Mary Donnelly, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9795 Issued in FL

Practice address

2804 Del Prado Blvd S Ste 202-1
Cape Coral, FL 33904-7252

Phone

(239) 989-9738

Fax

(866) 582-5875

NPI assigned

May 27, 2006

Last updated

Mar 13, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 15, 2024 through May 15, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mary a Donnelly

  • Mental Health Counselor
  • Cape Coral, FL
  • NPI 1649567470
  NPD (past) Authorized official
• Materia Medica

  • Preferred Provider Organization
  • Cape Coral, FL
  • NPI 1538534888
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1205883386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 152974",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339152974",
            "telephone_number": "239-989-9738",
            "fax_number": "866-582-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 DEL PRADO BLVD S STE 202-1",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047252",
            "telephone_number": "239-989-9738",
            "fax_number": "866-582-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "MARY",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "9795",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4003",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misleiby Dominguez, RBT-25-407015
• Don E Williamson Odpa (Williamson Eye Center)
• Cecelia C Donald, ARNP
• Yanelis Donates Gonzalez, CBHCMS
• Heidi Lynn Donley
• Matthew F Donnelly, PAC
• Jennifer Leigh Donovan, APRN
• Doorstep Lab Services
• Dora Cario (Nourish Wellness Center)
• Dilian Dorado Milian

• Mental Health Counselor in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.