Provider Demographics
NPI:1215292537
Name:TROY, MARY LUCILLE (MS, NCC, LPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LUCILLE
Last Name:TROY
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:DOYLE
Other - Last Name:TROY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, NCC, LPC
Mailing Address - Street 1:425 JESSUP ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-2010
Mailing Address - Country:US
Mailing Address - Phone:570-969-0449
Mailing Address - Fax:570-969-0449
Practice Address - Street 1:3 W OLIVE ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2572
Practice Address - Country:US
Practice Address - Phone:570-498-5593
Practice Address - Fax:570-969-0449
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002617101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional