Provider Demographics
NPI:1487789319
Name:WILLEY, MARIA O (MA, LCMFT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:O
Last Name:WILLEY
Suffix:
Gender:F
Credentials:MA, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 WATERLOO RD STE 230
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-1943
Mailing Address - Country:US
Mailing Address - Phone:410-757-2077
Mailing Address - Fax:443-782-2342
Practice Address - Street 1:5850 WATERLOO RD STE 230
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1943
Practice Address - Country:US
Practice Address - Phone:410-757-2077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA762106H00000X
MDLCM1010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist