Provider Demographics
NPI:1346303369
Name:YORK, MARY ELIZABETH (LCSW-R)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:YORK
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 BAY ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3031
Mailing Address - Country:US
Mailing Address - Phone:518-636-3778
Mailing Address - Fax:518-244-8960
Practice Address - Street 1:92 BAY ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3031
Practice Address - Country:US
Practice Address - Phone:518-636-3778
Practice Address - Fax:518-244-8960
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR044854-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical