Provider Demographics
NPI:1538476825
Name:SCHILLER, MARY LYNNE (LCSW-R)
Entity Type:Individual
Prefix:
First Name:MARY LYNNE
Middle Name:
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 EAST CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965
Mailing Address - Country:US
Mailing Address - Phone:845-304-4282
Mailing Address - Fax:
Practice Address - Street 1:132 EAST CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965
Practice Address - Country:US
Practice Address - Phone:845-304-4282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0728811041C0700X
NYR0728811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical