Provider Demographics
NPI:1891184818
Name:MCINDOE, MARY K (LPC, LCPC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:MCINDOE
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13214 PINE RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4746
Mailing Address - Country:US
Mailing Address - Phone:240-206-6064
Mailing Address - Fax:013-809-0495
Practice Address - Street 1:13214 PINE RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4746
Practice Address - Country:US
Practice Address - Phone:240-206-6064
Practice Address - Fax:301-809-0495
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5658101Y00000X
VA0701005995101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor