Provider Demographics
NPI:1801196001
Name:SANDONE, MARY (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SANDONE
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 1:712 CITY HALL
Mailing Address - Street 2:BUFFALO BOARD OF EDUCATION
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202
Mailing Address - Country:US
Mailing Address - Phone:716-816-3575
Mailing Address - Fax:
Practice Address - Street 1:712 CITY HALL
Practice Address - Street 2:BUFFALO BOARD OF EDUCATION
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-3307
Practice Address - Country:US
Practice Address - Phone:716-816-3575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR039045104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker