National Provider Identifier

Elizabeth Anne Mammarello, LCSW

Elizabeth Anne Mammarello, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Geneva, NY and a listed phone number of (315) 789-2613.

NPI 1316412091Geneva, NYClinical Social Worker

Profile Overview

NPI
1316412091
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
October 09, 2018
Last Updated
December 10, 2024

Practice Location

  • 671 Exchange St
  • Geneva, NY 14456-3498

Phone: (315) 789-2613

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1316412091
Entity Type
Individual
Last Name
Mammarello
First Name
Elizabeth
Middle Name
Anne
Name Prefix
Miss
Credential
LCSW
Provider Other Last Name
Widrick
Provider Other First Name
Elizabeth
Provider Other Middle Name
Anne
Provider Other Credential Text
LMSW
Provider Other Last Name Type Code
1
Mailing Street Address
671 Exchange St
Mailing City
Geneva
Mailing State
NY
Mailing ZIP Code
14456-3498
Mailing Country
US
Practice Street Address
671 Exchange St
Practice City
Geneva
Practice State
NY
Practice ZIP Code
14456-3498
Practice Country
US
Practice Phone
(315) 789-2613
Enumeration Date
October 09, 2018
Last Updated
December 10, 2024
Sex
Female
Sole Proprietor
No
Certification Date
December 10, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)