Doctor Name: | MS. MARY AMANDA WHARTON |
NPI Number: | 1356775837 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | DP02943348 |
Business Practice Address: | 354 Givens Ln Berkeley Springs, WV - 254116549 |
Business Phone Number: | 3042684782 |
Business Fax Number: | |
Mailing Address: | 354 Givens Ln, BERKELEY SPRINGS |
State: | WV |
Postal Code: | 254116549 |
Phone Number: | 3042684782 |
Fax Number: | |
NPI Enumeration Date: | 09/03/2013 |
NPI Last Update Date: | 09/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | DP02943348 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |