Provider Demographics
NPI:1447245949
Name:ONSTEAD, MARY ALICE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ALICE
Last Name:ONSTEAD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:A
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:40 SANFORD RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4538
Mailing Address - Country:US
Mailing Address - Phone:814-279-2521
Mailing Address - Fax:
Practice Address - Street 1:267 PLANK RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2324
Practice Address - Country:US
Practice Address - Phone:814-445-9930
Practice Address - Fax:814-445-9941
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0146461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA077084Medicare ID - Type Unspecified