Provider Demographics
NPI:1831674951
Name:NOA-KEMPNER, MARY (LMHC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:NOA-KEMPNER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 FARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-2206
Mailing Address - Country:US
Mailing Address - Phone:754-264-2959
Mailing Address - Fax:954-357-4816
Practice Address - Street 1:21 FARVIEW AVE
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-2206
Practice Address - Country:US
Practice Address - Phone:754-264-2959
Practice Address - Fax:954-357-4816
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12431779-6004101YM0800X
FLMH3157101YM0800X
NVCP5153-R101YP2500X
MNCC03645101YP2500X
CALPCC14742101YP2500X
CT003903101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health