Provider Demographics
NPI:1669544185
Name:MOREL, MARY E (MA, LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:MOREL
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10225 ULMERTON RD 8B
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3522
Mailing Address - Country:US
Mailing Address - Phone:727-586-0636
Mailing Address - Fax:727-585-6287
Practice Address - Street 1:10225 ULMERTON RD STE 8B
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3522
Practice Address - Country:US
Practice Address - Phone:727-586-0636
Practice Address - Fax:727-585-6287
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW27221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ4256ZMedicare ID - Type UnspecifiedLCSW