Provider Demographics
NPI:1457511313
Name:LENNEY, MARY YVONNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:YVONNE
Last Name:LENNEY
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 1:8C SEABREEZE AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460
Mailing Address - Country:US
Mailing Address - Phone:203-283-4357
Mailing Address - Fax:203-283-4357
Practice Address - Street 1:8 SEABREEZE AVE APT C
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-7946
Practice Address - Country:US
Practice Address - Phone:203-283-4357
Practice Address - Fax:203-283-4357
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0042591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical