Provider Demographics
NPI:1477540581
Name:WITHERBY, MARGARET PRATT (SW LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:PRATT
Last Name:WITHERBY
Suffix:
Gender:F
Credentials:SW LCSW
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:CLARKE
Other - Last Name:PRATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1076 CAYUGA DRIVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-2512
Mailing Address - Country:US
Mailing Address - Phone:716-213-8933
Mailing Address - Fax:716-283-2951
Practice Address - Street 1:1076 CAYUGA DRIVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-2512
Practice Address - Country:US
Practice Address - Phone:716-213-8933
Practice Address - Fax:716-283-2951
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC72711041C0700X
NY07554211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEW1ME0519Medicare ID - Type UnspecifiedLCSW