Provider Demographics
NPI:1023378213
Name:WORKMAN, MARY KAY (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:KAY
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23721 S DAY HILL RD
Mailing Address - Street 2:
Mailing Address - City:ESTACADA
Mailing Address - State:OR
Mailing Address - Zip Code:97023-9401
Mailing Address - Country:US
Mailing Address - Phone:503-630-3668
Mailing Address - Fax:
Practice Address - Street 1:23721 S DAY HILL RD
Practice Address - Street 2:
Practice Address - City:ESTACADA
Practice Address - State:OR
Practice Address - Zip Code:97023-9401
Practice Address - Country:US
Practice Address - Phone:503-630-3668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCO 499101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional