| Mary Ann Whalen, Lcsw, Llc | |
|
28017 Oceana Dr Bonita Springs FL 34135-8630 | |
| (707) 694-9524 | |
| Not Available |
| Full Name | Mary Ann Whalen, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 28017 Oceana Dr, Bonita Springs, Florida |
| Authorized Official Name and Position | Mary Ann Whalen (OWNER) |
| Authorized Official Contact | 7076949524 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Ann Whalen, Lcsw, Llc 28017 Oceana Dr Bonita Springs FL 34135-8630 Ph: (707) 694-9524 | Mary Ann Whalen, Lcsw, Llc 28017 Oceana Dr Bonita Springs FL 34135-8630 Ph: (707) 694-9524 |
| NPI Number | 1538721857 |
|---|---|
| Provider Enumeration Date | 07/08/2019 |
| Last Update Date | 06/22/2020 |
| Certification Date | 06/22/2020 |
| Medicare PECOS PAC ID | 0345576831 |
|---|---|
| Medicare Enrollment ID | O20190722001012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538721857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mary A Whalen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770675472 PECOS PAC ID: 8426283003 Enrollment ID: I20131107000859 |
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