NPIMap

Organization Active NPI

Mary a Donnelly

  • Mental Health Counselor
  • Cape Coral, FL
National Provider Identifier
1649567470
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9795 Issued in FL
Legal business name
MARY A DONNELLY
Practice address
2804 Del Prado Blvd S Ste 202-1
Cape Coral, FL 33904-7282
Phone
(239) 989-9738
NPI assigned
Jun 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Authorized official

Name
Mary Donnelly, LPC, LMHCNPI 1205883386
Title
Owner
Phone
(704) 453-3413

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 9795 FL Primary

Addresses

Primary practice location

2804 Del Prado Blvd S Ste 202-1
Cape Coral, FL 33904-7282

Mailing address

PO Box 152974
Cape Coral, FL 33915-2974

National Provider Directory

National Provider Directory

Locations

2804 Del Prado Blvd S
Ste 202-1
Cape Coral, FL 33904
Phone (239) 989-9738

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1649567470",
    "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"
        },
        {
            "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": "339047282",
            "telephone_number": "239-989-9738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY A DONNELLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-453-3413",
        "authorized_official_credential": "LPC, LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "9795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.