MARY LOU PRENDERGAST (NPI# 1730528381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730528381 |
| Entity Type | Individual |
| Full Name | MARY LOU PRENDERGAST |
| Credential | L.M.H.C. |
| Practice Address |
1660 Prudential Dr Ste 410 Jacksonville FL 32207 |
| Mailing Address |
Po Box 44230 Jacksonville FL 32231-4230 |
| Practice Telephone | 9043763800 |
| Practice Fax Number | 9043968966 |
| Mailing Telephone | 9043763800 |
| Mailing Fax Number | 9043763998 |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2019-09-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH 10308 | FL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 328 Stiles Ave, Suite 3, Orange Park, FL 320734015 | 9042648311 | 9042648377 |
| 841 Prudential Dr Fl 10, Jacksonville, FL 32207 | 9043763800 | 9043968975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659770071 | Mary Beth Prendergast | Registered Nurse | 3851 Rosecrans St, San Diego, CA 92110-3115 | 2014-08-21 |
| 1235481292 | Mary Prendergast | Counselor | 4200 Edmondson Ave, Baltimore, MD 21229-1612 | 2012-10-15 |
| 1386678878 | Mary Prendergast | Internal Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2006-07-10 |
| Street Address |
1660 PRUDENTIAL DR STE 410 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023038072 | John P Byron | Psychologist | 1660 Prudential Dr Ste 410, Jacksonville, FL 32207-8197 | 2006-07-20 |
| 1306237649 | Marianna Georgiadou | Counselor | 1660 Prudential Dr Ste 410, Jacksonville, FL 32207-8197 | 2015-02-09 |
| 1972886323 | Michelle C Taveras | Psychologist | 1660 Prudential Dr Ste 410, Jacksonville, FL 32207-8197 | 2011-09-22 |
| 1821221615 | Stefanie Schwartz | Psychologist | 1660 Prudential Dr Ste 410, Jacksonville, FL 32207-8197 | 2009-08-27 |
| 1467680660 | Shariq Refai | Psychiatry & Neurology | 1660 Prudential Dr Ste 410, Jacksonville, FL 32207-8197 | 2009-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720519 | Ashley Harms | Counselor | 4070 Herschel St Ste 1, Jacksonville, FL 32210-2239 | 2020-11-03 |
| 1902418684 | Molly Ann Burkhardt | Counselor | 5776 Saint Augustine Rd # 8030, Jacksonville, FL 32207-8046 | 2020-08-23 |
| 1194335638 | Aiteria Green | Counselor | 9713 Bridgeway Ave, Jacksonville, FL 32222-2913 | 2020-08-07 |
| 1053920116 | Barbara Burden | Counselor | 209 N Carole Dr, Jacksonville, NC 28546-4845 | 2020-07-24 |
| 1790393973 | Kelley Holladay | Counselor | 1782 Plantation Oaks Dr, Jacksonville, FL 32223-5010 | 2020-07-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1447877709 | Quendria Johnson-kerns | Counselor | 200 Zonnie Ln, Jacksonville, NC 28540-9729 | 2020-07-02 |
| 1467077164 | Shanna Horan | Counselor | 13500 Sutton Park Dr S Ste 702, Jacksonville, FL 32224-5290 | 2020-06-09 |
| 1720602527 | Shannon E Raikes | Counselor | 13990 Bartram Park Blvd Unit 209, Jacksonville, FL 32258-5543 | 2020-06-08 |
| 1750905253 | Kathlena N Reed | Counselor | 4131 University Blvd S Fl 32216, Jacksonville, FL 32216-4326 | 2020-06-01 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on MARY LOU PRENDERGAST.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.