Anderson, Mary
Anderson, Mary is an individual health care provider with primary practice located at 9 Baywood Ln , Bayport NY 11705-1727. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Anderson, Mary can be contacted via phone (631) 941-9494.Contact Information
Primary practice address
9 Baywood Ln
Bayport NY 11705-1727
Phone: (631) 941-9494
Fax: (631) 941-9494
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R0505421 |
Profile Details
| NPI number | 1245329796 |
|---|---|
| LBN Legal business name | Anderson, Mary |
| Credentials | LCSWR |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Jun 8th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245329796 | NPPES |
| New York | MEDICAID | 61020463081 |
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