Provider Demographics
NPI:1851344733
Name:FOURES, MARY ANN (LMHC; CEAP)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:FOURES
Suffix:
Gender:F
Credentials:LMHC; CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4440
Mailing Address - Country:US
Mailing Address - Phone:239-435-1606
Mailing Address - Fax:239-435-1607
Practice Address - Street 1:2375 TAMIAMI TRL N
Practice Address - Street 2:SUITE 306
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4440
Practice Address - Country:US
Practice Address - Phone:239-435-1606
Practice Address - Fax:239-435-1607
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH342101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health