Provider Demographics
NPI:1417087610
Name:ABBETT, MARY PATRICIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:PATRICIA
Last Name:ABBETT
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:PO BOX 5222
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81658-5222
Mailing Address - Country:US
Mailing Address - Phone:970-376-5961
Mailing Address - Fax:
Practice Address - Street 1:953 S FRONTAGE RD W
Practice Address - Street 2:SUITE 101
Practice Address - City:VAIL
Practice Address - State:CO
Practice Address - Zip Code:81657-5710
Practice Address - Country:US
Practice Address - Phone:970-376-5961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9918941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical