MRS. MARY ELLEN THEODORE LPC
NPI 1699933630
Counselor - Mental Health in Maryville, MO

Q: What is Mary Theodore's NPI number?

The NPI number for Mary Theodore is 1699933630. It was assigned to this individual provider in the NPPES registry on May 27, 2008.

Q: What is Mary Theodore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Mary Theodore was last updated on May 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 27, 2008

321 N MUNN AVE, MARYVILLE, MO 64468(660) 582-3086(660) 582-3086 Get Directions Write a Review

NPPES record last updated: May 27, 2008. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Mrs. Mary Ellen Theodore Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MARY ELLEN THEODORE LPC (NPI 1699933630) is an individual mental health provider in Maryville, Missouri, licensed in Missouri (002394) and active in the NPI registry since May 2008.

NPPES Registry Identity

NPI1699933630

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMRS. MARY ELLEN THEODORECredential: LPC

Location Address321 N MUNN AVEMaryville, MO 64468-2146

Mailing Address321 N Munn AveMaryville, MO 64468-2146 · (660) 582-3086 · Fax (660) 582-3086

Phone(660) 582-3086

Fax(660) 582-3086

Sole ProprietorYes

Enumeration DateMay 27, 2008

✔ NPI 1699933630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in MO · 002394

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 002394 (MO)

321 N MUNN AVE, Maryville, MO 64468

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Theodore's NPI number?

The NPI number for Mary Theodore is 1699933630. It was assigned to this individual provider in the NPPES registry on May 27, 2008.

Where is Mary Theodore located?

Mary Theodore practices at 321 N Munn Ave, Maryville, MO 64468. The listed phone number is (660) 582-3086.

What is Mary Theodore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Mary Theodore was last updated on May 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.