Mary Louise Poley, LMHC INTERN

Individual provider Active NPI Mental Health Counselor · Jay, FL

NPI 1295608339 · NPPES record last updated Sep 25, 2025

Key facts

NPI
1295608339
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
IMH28102 (FL)
Practice address
5166 Highway 182
Jay, FL 32565-9357
Phone
(850) 910-1326
NPI assigned
Sep 25, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
IMH28102FLMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH28102 FL Yes

Addresses

Primary practice location

5166 Highway 182
Jay, FL 32565-9357

Mailing address

5166 Highway 182
Jay, FL 32565-9357
Phone (850) 910-1326

Other providers in Jay, FL

All providers in Jay, FL · Mental Health Counselor in Florida

Sources for this page

Verify at the official NPI Registry.