Doctor Name: | MARY D HENNESSY |
NPI Number: | 1508055773 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 025168 |
Business Practice Address: | 30 Benner Rd Red Hook, NY - 125711543 |
Business Phone Number: | 8457580241 |
Business Fax Number: | |
Mailing Address: | 34 Teator Ln, RED HOOK |
State: | NY |
Postal Code: | 125712389 |
Phone Number: | 8457580241 |
Fax Number: | |
NPI Enumeration Date: | 10/23/2007 |
NPI Last Update Date: | 10/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 025168 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |