Provider Demographics
NPI:1295349876
Name:COFFEY, MARALEE SYERS (LCPC, LCPAT, ATR-BC)
Entity type:Individual
Prefix:
First Name:MARALEE
Middle Name:SYERS
Last Name:COFFEY
Suffix:
Gender:F
Credentials:LCPC, LCPAT, ATR-BC
Other - Prefix:
Other - First Name:MARALEE
Other - Middle Name:
Other - Last Name:SYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC, LCPAT, ATR-BC
Mailing Address - Street 1:5104 PEGASUS CT STE B
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-8323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5104 PEGASUS CT STE B
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-8323
Practice Address - Country:US
Practice Address - Phone:240-394-7714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDATC198221700000X
MDLC9037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist