Provider Demographics
NPI:1528205986
Name:JONES-CLAVELL, MARY LOUISE (LMSW, LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LOUISE
Last Name:JONES-CLAVELL
Suffix:
Gender:F
Credentials:LMSW, LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 LAURENTIAN DR
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225
Mailing Address - Country:US
Mailing Address - Phone:716-897-5499
Mailing Address - Fax:716-896-0374
Practice Address - Street 1:951 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-2116
Practice Address - Country:US
Practice Address - Phone:716-884-0700
Practice Address - Fax:716-884-0631
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR072768-11041C0700X
NYR066230-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical