Provider Demographics
NPI:1073849857
Name:ABERNETHY, MARY SUE (LMFT)
Entity type:Individual
Prefix:
First Name:MARY SUE
Middle Name:
Last Name:ABERNETHY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 HACIENDA CARMEL
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-7946
Mailing Address - Country:US
Mailing Address - Phone:831-809-0999
Mailing Address - Fax:
Practice Address - Street 1:162 HACIENDA CARMEL
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-7946
Practice Address - Country:US
Practice Address - Phone:831-809-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37179106H00000X
CAMFC 37179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist