Provider Demographics
NPI:1952847543
Name:MARY CLARYS COUNSELING, LLC
Entity Type:Organization
Organization Name:MARY CLARYS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:CLARYS
Authorized Official - Suffix:
Authorized Official - Credentials:PLMHP
Authorized Official - Phone:402-889-0981
Mailing Address - Street 1:3677 N 129TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-5211
Mailing Address - Country:US
Mailing Address - Phone:402-819-4942
Mailing Address - Fax:
Practice Address - Street 1:3677 N 129TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-5211
Practice Address - Country:US
Practice Address - Phone:402-819-4942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10769101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty