Provider Demographics
NPI:1194744789
Name:CANANE, MARY (LMHC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:CANANE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15895 66TH CT N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3426
Mailing Address - Country:US
Mailing Address - Phone:561-795-9695
Mailing Address - Fax:561-792-8865
Practice Address - Street 1:1480 ROYAL PALM BEACH BLVD.
Practice Address - Street 2:SUITE C
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1608
Practice Address - Country:US
Practice Address - Phone:561-301-5355
Practice Address - Fax:561-792-8865
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0002141174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL088446OtherVALUE OPTIONS
FL2719342OtherAETNA
FL239645000OtherMAGELLAN
FL124291OtherPSYCHCARE
FL6241056OtherUBH