Provider Demographics
NPI:1780628636
Name:WEBB, MARY E (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:WEBB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CASE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2222
Mailing Address - Country:US
Mailing Address - Phone:860-942-1424
Mailing Address - Fax:
Practice Address - Street 1:12 CASE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2222
Practice Address - Country:US
Practice Address - Phone:860-942-1424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0057951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical