Provider Demographics
NPI:1003995978
Name:KIERNAN-STERN, MARY ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:KIERNAN-STERN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120A OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-3285
Mailing Address - Country:US
Mailing Address - Phone:703-966-4453
Mailing Address - Fax:
Practice Address - Street 1:119C W.FREDERICK ST.
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-3285
Practice Address - Country:US
Practice Address - Phone:703-966-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040027671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical