Provider Demographics
NPI:1831494715
Name:ARBAUGH, MARY ANGELA (LMFT, LBA, BCBA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANGELA
Last Name:ARBAUGH
Suffix:
Gender:F
Credentials:LMFT, LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 S BUCKMAN ST
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-6060
Mailing Address - Country:US
Mailing Address - Phone:502-468-4640
Mailing Address - Fax:
Practice Address - Street 1:345 S BUCKMAN ST
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6060
Practice Address - Country:US
Practice Address - Phone:502-468-4640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY164239103K00000X
KY0870106H00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist