# MRS. MARY SUE FONKERT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1245327584
- **Gender:** F
- **Credential:** M.S.W., L.C.S.W.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 1852 | SD | Yes |

## Other

- **Enumeration date:** 10/06/2006
- **Last updated:** 07/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 177544 | MENTAL HEALTH | SD |
| 01 | — | 41548 | MENTAL HEALTH PROVIDER | SD |
| 01 | — | 4996672 | MENTAL HEALTH PROVIDER | SD |
| 05 | — | 6570960 | — | SD |
| 01 | — | 96869 | MENTAL HEALTH PROVIDER | SD |