Individual provider · Type 1 NPI

Lisa Marie Mango, MS.

Mental Health Counselor · Fort Pierce, FL

NPI number 1649819699 Active

Practice location

2222 Colonial Rd Ste 100
Fort Pierce, FL 34950-5309

Call (772) 489-4726 Map

Mailing address

8923 Oldham Way
Palm Beach Gardens, FL 33412-1110

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XCAP3115 (FL)
Mental Health Counselor Primary 101YM0800X101YM0800X (FL)
Addiction (Substance Use Disorder) Counselor 101YA0400XCAP3115 (FL)
Mental Health Counselor 101YM0800X101YM0800X

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About NPI 1649819699

Lisa Marie Mango, MS.'s National Provider Identifier is 1649819699, issued on Dec 21, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fort Pierce, FL. The record was last updated on May 10, 2022.