Provider Demographics
NPI:1598904443
Name:LAMAZARES, MARY C (LMHC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:LAMAZARES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12231 SW 94TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1913
Mailing Address - Country:US
Mailing Address - Phone:305-962-0366
Mailing Address - Fax:305-271-9926
Practice Address - Street 1:3414 W 84TH ST STE 100
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4932
Practice Address - Country:US
Practice Address - Phone:786-313-3558
Practice Address - Fax:786-360-5803
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7355101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health