Provider Demographics
NPI:1598045668
Name:MAYO, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:MAYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3086 CRANBERRY HWY
Mailing Address - Street 2:HABIT OPCO; ATTN: M.MAYO, CLINICIAN
Mailing Address - City:EAST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02538-4801
Mailing Address - Country:US
Mailing Address - Phone:508-295-7990
Mailing Address - Fax:508-295-3781
Practice Address - Street 1:3086 CRANBERRY HWY
Practice Address - Street 2:HABIT OPCO; ATTN: M.MAYO, CLINICIAN
Practice Address - City:EAST WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02538-4801
Practice Address - Country:US
Practice Address - Phone:508-295-7990
Practice Address - Fax:508-295-3781
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist