Provider Demographics
NPI:1043532997
Name:STINSON, MARY E (LMHC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:STINSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 62ND STREET CIR E STE 101
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-6208
Mailing Address - Country:US
Mailing Address - Phone:941-725-3977
Mailing Address - Fax:
Practice Address - Street 1:703 C 60TH STREET COURT EAST
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-6266
Practice Address - Country:US
Practice Address - Phone:941-725-3977
Practice Address - Fax:941-729-3299
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health