National Provider Identifier

Mary Ann Wilson, LCSW-R

Mary Ann Wilson, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Penfield, NY and a listed phone number of (585) 690-0890.

NPI 1760664338Penfield, NYClinical Social Worker

Profile Overview

NPI
1760664338
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
December 05, 2007
Last Updated
January 13, 2025

Practice Location

  • 2130 Five Mile Line RD
  • Penfield, NY 14526-2292

Phone: (585) 690-0890

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1760664338
Entity Type
Individual
Last Name
Wilson
First Name
Mary Ann
Credential
LCSW-R
Mailing Street Address
2130 Five Mile Line RD
Mailing City
Penfield
Mailing State
NY
Mailing ZIP Code
14526-2292
Mailing Country
US
Mailing Phone
(585) 690-0890
Practice Street Address
2130 Five Mile Line RD
Practice City
Penfield
Practice State
NY
Practice ZIP Code
14526-2292
Practice Country
US
Practice Phone
(585) 690-0890
Enumeration Date
December 05, 2007
Last Updated
January 13, 2025
Sex
Female
Sole Proprietor
No
Certification Date
December 31, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)
Other Identifiers
03350007 (NY)