Provider Demographics
NPI:1699834895
Name:KING-LINARES, MARY THERESA (MCAT,ADTR,LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:THERESA
Last Name:KING-LINARES
Suffix:
Gender:F
Credentials:MCAT,ADTR,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 SAINT JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-5236
Mailing Address - Country:US
Mailing Address - Phone:717-291-1012
Mailing Address - Fax:
Practice Address - Street 1:545 PERSHING AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-4369
Practice Address - Country:US
Practice Address - Phone:717-293-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001215101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional