Mary A Bourne
Individual provider Active NPI Professional Counselor · Tyrone, PA
NPI 1679446579 · NPPES record last updated Sep 26, 2025
Key facts
- NPI
- 1679446579
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- APC001745 (PA)
- Practice address
- 2308 Adams Ave
Tyrone, PA 16686-2353 - Phone
- (724) 396-1510
- Fax
- (724) 972-4627
- NPI assigned
- Sep 26, 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
| License | State | Type | Specialty |
|---|---|---|---|
| APC001745 | PA | MD | Professional Counselor |
| AMF000098 | PA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | APC001745 | PA | Yes |
| Marriage & Family Therapist |
106H00000X | AMF000098 | PA |
Addresses
Primary practice location
2308 Adams Ave
Tyrone, PA 16686-2353
Mailing address
101 Pembroke CT
Greensburg, PA 15601-6404
Phone (724) 396-1510
Other providers in Tyrone, PA
- Jason E. Bihary
- Blair Medical Associates
- Blair Medical Associates - Tyrone
- David Randall Bokulich
- Ashley Bonsell
- Breaking Barriers Counseling LLC
- Jacob Buchanan
- Elena Jo Caracciolo
- Central Anesthesia LLC
- Central Penn Vision Associates
All providers in Tyrone, PA · Professional Counselor in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.