Individual
MS. MARY THERESA ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LPC NCC MAC CPCS
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003709
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10063295
AMERIGROUP
GA
01
—
10063297
AMERIGROUP
GA
05
—
129577652A
—
GA
01
—
1427124593
BCBS
GA
01
—
5732533
AETNA
GA
01
—
582262349
HUMANA
GA
01
—
726881000
MAGELLAN
GA
Enumeration date
11/28/2006
Last updated
04/09/2024
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