Provider Demographics
NPI:1104493956
Name:MAHER, ABIGAIL (MA, NCC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 CENTRAL AVE UNIT 209
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1640
Mailing Address - Country:US
Mailing Address - Phone:813-453-8123
Mailing Address - Fax:
Practice Address - Street 1:930 CENTRAL AVE UNIT 209
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1640
Practice Address - Country:US
Practice Address - Phone:813-453-8123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21738101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH21738OtherMENTAL HEALTH COUNSELOR LICENSE