National Provider Identifier
Mary Jo Gervase, LCSW-R
Mary Jo Gervase, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Buffalo, NY and a listed phone number of (716) 838-0614.
Profile Overview
- NPI
- 1508138777
- Provider Type
- Individual
- Primary Specialty
- Clinical Social Worker
- Enumeration Date
- February 03, 2012
- Last Updated
- February 03, 2012
Practice Location
- 311 Woodward Ave
- Buffalo, NY 14214-1961
Phone: (716) 838-0614
Specialties
- Clinical Social Worker (1041C0700X)
Full Record
- NPI
- 1508138777
- Entity Type
- Individual
- Last Name
- Gervase
- First Name
- Mary Jo
- Credential
- LCSW-R
- Mailing Street Address
- 311 Woodward Ave
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14214-1961
- Mailing Country
- US
- Mailing Phone
- (716) 838-0614
- Practice Street Address
- 311 Woodward Ave
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14214-1961
- Practice Country
- US
- Practice Phone
- (716) 838-0614
- Enumeration Date
- February 03, 2012
- Last Updated
- February 03, 2012
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Clinical Social Worker (1041C0700X)