Provider Demographics
NPI:1578626313
Name:REMINGTON, MARY E (LMFT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:REMINGTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 ASHBY AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1884
Mailing Address - Country:US
Mailing Address - Phone:510-835-4357
Mailing Address - Fax:510-835-4357
Practice Address - Street 1:2127 ASHBY AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1884
Practice Address - Country:US
Practice Address - Phone:510-835-4357
Practice Address - Fax:510-835-4357
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist