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NPI Code Detail

MEDICARE: MARY-KATE FRETT LACMH

MEDICARE: MARY-KATE FRETT LACMH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorAC-0010445DE
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1073012993
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY-KATE FRETT LACMH
Provider Business Mailing Address
First Line : 2049 WILDER ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19146-4524
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 650 NAAMANS RD STE 110
Second Line :
City : CLAYMONT
State : DE
Zip : 19703-2301
Country : US
Telephone Number : 302-224-1400
Fax Number : 302-224-1402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2018
Last Update Date : 09/05/2024

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Directions to “ MARY-KATE FRETT LACMH” Practice Location

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