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Individual
MARY-BETH PETERSEN-CLEARY
Active
Individual
MARY-BETH PETERSEN-CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-R
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00056518
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000302141501
UNIVERA
NY
01
—
000590325001
BLUECROSS/BLUESHIELD
NY
Enumeration date
05/04/2006
Last updated
06/05/2014
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