Provider Demographics
NPI:1093070963
Name:MARA, CATHERINE C (MS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:C
Last Name:MARA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3832 BRAEMERE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0678
Mailing Address - Country:US
Mailing Address - Phone:352-442-1717
Mailing Address - Fax:352-796-3990
Practice Address - Street 1:7074 GROVE RD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34609-8658
Practice Address - Country:US
Practice Address - Phone:352-540-9335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11873101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health