Provider Demographics
NPI:1417658709
Name:ENGLAND, MARY BETH (LPCA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BETH
Last Name:ENGLAND
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MUNFORDVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42765-9023
Mailing Address - Country:US
Mailing Address - Phone:270-696-3181
Mailing Address - Fax:
Practice Address - Street 1:103 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:MUNFORDVILLE
Practice Address - State:KY
Practice Address - Zip Code:42765-9023
Practice Address - Country:US
Practice Address - Phone:270-696-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
283642101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor