Provider Demographics
NPI:1174250427
Name:KINES, MARY (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:KINES
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N MOORE RD APT 1124
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5285
Mailing Address - Country:US
Mailing Address - Phone:940-290-1916
Mailing Address - Fax:
Practice Address - Street 1:215 N MOORE RD APT 1124
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5285
Practice Address - Country:US
Practice Address - Phone:940-290-1916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health