Provider Demographics
NPI:1598080954
Name:LEFAIVE, MARY ELIZABETH (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:LEFAIVE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11042 NICHOLAS LN
Mailing Address - Street 2:B103
Mailing Address - City:OCEAN PINES
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3299
Mailing Address - Country:US
Mailing Address - Phone:410-208-4784
Mailing Address - Fax:410-208-4786
Practice Address - Street 1:11042 NICHOLAS LN
Practice Address - Street 2:B103
Practice Address - City:OCEAN PINES
Practice Address - State:MD
Practice Address - Zip Code:21811-3299
Practice Address - Country:US
Practice Address - Phone:410-208-4784
Practice Address - Fax:410-208-4786
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD157841041C0700X
DEQ1-00006901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical