MARY FUNG-A-FAT LPC
NPI 1710674635
Counselor - Mental Health in Philadelphia, PA
About Mary Fung-a-fat Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY FUNG-A-FAT LPC (NPI 1710674635) is an individual mental health provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PC019903) and active in the NPI registry since April 2023. She has opted out of Medicare through February 9, 2028.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Mary Fung-a-fat Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 9, 2026 through February 9, 2028.
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHILADELPHIA, PA 19110
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 Fung-a-fat's NPI number?
The NPI number for Mary Fung-a-fat is 1710674635. It was assigned to this individual provider in the NPPES registry on April 20, 2023.
Where is Mary Fung-a-fat located?
Mary Fung-a-fat practices at 100 S Broad St Ste 1920, Philadelphia, PA 19110. The listed phone number is (267) 838-0066.
What is Mary Fung-a-fat's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Mary Fung-a-fat enrolled in Medicare?
No. Mary Fung-a-fat has opted out of Medicare through February 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Mary Fung-a-fat was last updated on March 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.
# Mary Fung-A-Fat, LPC · NPI 1710674635
Mental Health provider in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since April 20, 2023.
## Identity
- **NPI:** 1710674635 (Entity type: Individual)
- **Enumerated:** April 20, 2023
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** PC019903 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 100 S BROAD ST STE 1920, Philadelphia, PA 19110-1064
- **Phone:** (267) 838-0066
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through February 9, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** March 26, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1710674635) · Data from the CMS NPPES public registry.