Leonardo, Mary Grace

Leonardo, Mary Grace is an sole proprietor health care provider with primary practice located at 250 Hillcrest Rd , Ithaca NY 14850-9747. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / School is her primary health care specialty. Leonardo, Mary Grace can be contacted via phone (607) 279-9034.

Contact Information

Primary practice address
250 Hillcrest Rd Ithaca NY 14850-9747
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 069733 New York
Behavioral Health & Social Service Providers / School 1041S0200X 539776041 New York

Profile Details

NPI number 1104026327
LBN Legal business name Leonardo, Mary Grace
Credentials LCSW-R
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 25th, 2007
Last updated Jan 23rd, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104026327 NPPES
New York Other 553866 VALUE OPTIONS

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