Provider Demographics
NPI:1114270196
Name:MABRY, YASMEEN (LCPC)
Entity Type:Individual
Prefix:
First Name:YASMEEN
Middle Name:
Last Name:MABRY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 LANDMARK DR
Mailing Address - Street 2:SUITE 118
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4486
Mailing Address - Country:US
Mailing Address - Phone:410-863-7213
Mailing Address - Fax:410-863-7205
Practice Address - Street 1:804 LANDMARK DR
Practice Address - Street 2:SUITE 118
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4486
Practice Address - Country:US
Practice Address - Phone:410-863-7213
Practice Address - Fax:410-863-7205
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4449101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health