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Individual
MS. MARY CLARE
Active
Individual
MS. MARY CLARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R045025-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201838
COMPSYCH PIN
—
01
—
270175
VALUE OPTIONS PIN
—
01
—
322592
MHN PIN
—
01
—
553863000
MAGELLAN
—
01
—
7272513
AETNA PIN
—
01
—
MDH 240
PREFERRED CARE PIN
—
01
—
P010045025
EXCELLUS PIN
—
Enumeration date
02/27/2006
Last updated
04/16/2020
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