National Provider Identifier
Mary Wallis, LCSW
Mary Wallis, LCSW is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Elmira, NY and a listed phone number of (607) 737-4745.
Profile Overview
- NPI
- 1447689971
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- November 05, 2013
- Last Updated
- March 07, 2018
Practice Location
- 100 Washington St
- Elmira, NY 14901-2849
Phone: (607) 737-4745
Mailing Address
- 115 Liberty St
- Bath, NY 14810-1508
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1447689971
- Entity Type
- Individual
- Last Name
- Wallis
- First Name
- Mary
- Name Prefix
- MS.
- Credential
- LCSW
- Mailing Street Address
- 115 Liberty St
- Mailing City
- Bath
- Mailing State
- NY
- Mailing ZIP Code
- 14810-1508
- Mailing Country
- US
- Mailing Phone
- (607) 664-2255
- Practice Street Address
- 100 Washington St
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14901-2849
- Practice Country
- US
- Practice Phone
- (607) 737-4745
- Practice Fax
- (607) 737-4813
- Enumeration Date
- November 05, 2013
- Last Updated
- March 07, 2018
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)