Provider Demographics
NPI:1699186569
Name:BADENOCH, MARY ANN (LMHC, LPC, MAC)
Entity type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:BADENOCH
Suffix:
Gender:F
Credentials:LMHC, LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5970 BELLA ROSA LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-2191
Mailing Address - Country:US
Mailing Address - Phone:772-247-4277
Mailing Address - Fax:
Practice Address - Street 1:5970 BELLA ROSA LN
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-2191
Practice Address - Country:US
Practice Address - Phone:908-988-0930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH11774101YM0800X
NJ37PC00491100101YP2500X
NY007252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health