MEDICARE: MRS. MARY ALICE MANY L.P.C., L.M.F.T.

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
1	101YM0800X	Mental Health Counselor	2142	LA
2	101YP2500X	Professional Counselor	2142	LA
3	106H00000X	Marriage & Family Therapist	277	LA

General Provider Information

NPI Number	:	1740380310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY ALICE MANY L.P.C., L.M.F.T.

Provider Business Mailing Address
First Line	:	966 S RIVER RD
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-4200
Country	:	US
Telephone Number	:	225-791-1200
Fax Number	:	225-791-1206

Provider Business Practice Location Address
First Line	:	966 S RIVER RD
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-4200
Country	:	US
Telephone Number	:	225-791-1200
Fax Number	:	225-791-1206

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	09/11/2025

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