Provider Demographics
NPI:1215471552
Name:REMON, MARY (LMHC,CEAP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:REMON
Suffix:
Gender:F
Credentials:LMHC,CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SKOKIE BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1623
Mailing Address - Country:US
Mailing Address - Phone:305-705-5389
Mailing Address - Fax:832-514-3640
Practice Address - Street 1:333 SKOKIE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1623
Practice Address - Country:US
Practice Address - Phone:847-450-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5368101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health