Provider Demographics
NPI:1831716042
Name:MESA, MARANGELY (MS, LMHC)
Entity type:Individual
Prefix:
First Name:MARANGELY
Middle Name:
Last Name:MESA
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OFFICE PARK DR STE D
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3850
Mailing Address - Country:US
Mailing Address - Phone:386-243-5519
Mailing Address - Fax:844-691-1305
Practice Address - Street 1:2 OFFICE PARK DR STE D
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3850
Practice Address - Country:US
Practice Address - Phone:386-243-5519
Practice Address - Fax:844-691-1305
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-03
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health