Petersen, Mary Lorraine

Petersen, Mary Lorraine is an individual health care provider with primary practice located at 705 Hilltop Ct , Coram NY 11727. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Petersen, Mary Lorraine can be contacted via phone (631) 696-4355.

Contact Information

Primary practice address
705 Hilltop Ct Coram NY 11727
Phone: (631) 696-4355
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R023294 New York

Profile Details

NPI number 1710083084
LBN Legal business name Petersen, Mary Lorraine
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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