Provider Demographics
NPI:1265881106
Name:DOHERTY, MARGARET (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:DOHERTY
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5052 RING ROSE CT
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-8938
Mailing Address - Country:US
Mailing Address - Phone:850-964-2542
Mailing Address - Fax:
Practice Address - Street 1:7552 NAVARRE PKWY
Practice Address - Street 2:UNIT 45
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7309
Practice Address - Country:US
Practice Address - Phone:850-964-2542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60997032101YM0800X
CO13759101YM0800X, 101YM0800X
FLMH22096101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health