Healthcare Provider Details

I. General information

NPI: 1447829866
Provider Name (Legal Business Name): MARGARET KATHERINE PROULX LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 KIRKWOOD HWY # 1163
WILMINGTON DE
19808-6153
US

IV. Provider business mailing address

31110 SQUAW CREEK TRL
BALLSTON SPA NY
12020-2725
US

V. Phone/Fax

Practice location:
  • Phone: 352-322-5478
  • Fax:
Mailing address:
  • Phone: 920-579-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH22870
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number012868
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8893
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC-0011907
License Number StateDE
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10005219
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: