Healthcare Provider Details

I. General information

NPI: 1811550429
Provider Name (Legal Business Name): MARY ELIZABETH MARRS LMFT 129866
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 VILLAGE LN
CHICO CA
95926-2812
US

IV. Provider business mailing address

1045 VILLAGE LN
CHICO CA
95926-2812
US

V. Phone/Fax

Practice location:
  • Phone: 530-755-8828
  • Fax:
Mailing address:
  • Phone: 530-755-8828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number129866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: