Ventura, Mary Grace
Ventura, Mary Grace is an sole proprietor health care provider with primary practice located at 438 Adirondack Dr , Farmingville NY 11738-2041. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ventura, Mary Grace can be contacted via phone (631) 846-1908.Contact Information
Primary practice address
438 Adirondack Dr
Farmingville NY 11738-2041
Phone: (631) 846-1908
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | L037642R | New York |
Profile Details
| NPI number | 1225171606 |
|---|---|
| LBN Legal business name | Ventura, Mary Grace |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1225171606 | NPPES |
| New York | MEDICAID | 01540909 |
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