Provider Demographics
NPI:1154030815
Name:MENDY, MARIE JEANDERINE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:JEANDERINE
Last Name:MENDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442 CHESAPEAKE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-2204
Mailing Address - Country:US
Mailing Address - Phone:401-662-5591
Mailing Address - Fax:
Practice Address - Street 1:1442 CHESAPEAKE AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-2204
Practice Address - Country:US
Practice Address - Phone:401-662-5591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health