Warren, Mary Ellen

Warren, Mary Ellen is an individual health care provider with primary practice located at 4348 Electric Rd , Roanoke VA 24018-0720. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Warren, Mary Ellen can be contacted via phone (540) 769-0976.

Contact Information

Primary practice address
4348 Electric Rd Roanoke VA 24018-0720
Phone: (540) 769-0976
Fax: (540) 857-5385
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 633 South Carolina
Behavioral Health & Social Service Providers / Family 103TF0000X 633 South Carolina
Behavioral Health & Social Service Providers / School 103TS0200X 633 South Carolina
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810008462 Virginia

Profile Details

NPI number 1902904477
LBN Legal business name Warren, Mary Ellen
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Apr 11th, 2024 - about 8 months 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 1902904477 NPPES
South Carolina MEDICAID PS0409

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