Provider Demographics
NPI:1144597717
Name:FLANARY, MARY MOWBRAY (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MOWBRAY
Last Name:FLANARY
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 1:35 BRILLIANT DR
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-5879
Mailing Address - Country:US
Mailing Address - Phone:540-577-1044
Mailing Address - Fax:
Practice Address - Street 1:80 COLLEGE ST STE H
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-2985
Practice Address - Country:US
Practice Address - Phone:540-381-1848
Practice Address - Fax:540-381-5372
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-25
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040077941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical