Provider Demographics
NPI:1558791988
Name:HERRON, MARYLYNN (LMFT)
Entity type:Individual
Prefix:
First Name:MARYLYNN
Middle Name:
Last Name:HERRON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 PARKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-3946
Mailing Address - Country:US
Mailing Address - Phone:559-232-2276
Mailing Address - Fax:
Practice Address - Street 1:219 PARKDALE AVE
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-3946
Practice Address - Country:US
Practice Address - Phone:559-232-2276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-21
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health