Provider Demographics
NPI:1679712368
Name:SATTERTHWAITE, MARY RICHARDSON (LICSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:RICHARDSON
Last Name:SATTERTHWAITE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4049
Mailing Address - Country:US
Mailing Address - Phone:603-431-7308
Mailing Address - Fax:603-431-7308
Practice Address - Street 1:426 STATE STREET
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4049
Practice Address - Country:US
Practice Address - Phone:603-431-7308
Practice Address - Fax:603-431-7308
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH#3751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical