Provider Demographics
NPI:1154746717
Name:BYRNES, MARY ANNE (LMFT)
Entity type:Individual
Prefix:MISS
First Name:MARY
Middle Name:ANNE
Last Name:BYRNES
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 1:3735 N MOUNT JULIET RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3060
Mailing Address - Country:US
Mailing Address - Phone:615-516-3063
Mailing Address - Fax:
Practice Address - Street 1:3735 N MOUNT JULIET RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3060
Practice Address - Country:US
Practice Address - Phone:615-516-3063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN962106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist