Provider Demographics
NPI:1902955727
Name:ABLETT, MARY B (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:B
Last Name:ABLETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:ELLEN
Other - Last Name:ABLETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:183 FOREST BEND LN
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-3604
Mailing Address - Country:US
Mailing Address - Phone:817-598-0345
Mailing Address - Fax:817-598-9169
Practice Address - Street 1:7833 OAKMONT BLVD
Practice Address - Street 2:110
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4204
Practice Address - Country:US
Practice Address - Phone:817-665-0583
Practice Address - Fax:817-370-8977
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87618QOtherBCBS PROVIDER NUMBER