Provider Demographics
NPI:1205944881
Name:ALBRIGHT, MARY J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:J
Last Name:ALBRIGHT
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 1:1307 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-3405
Mailing Address - Country:US
Mailing Address - Phone:636-933-2470
Mailing Address - Fax:
Practice Address - Street 1:9735 LANDMARK PARKWAY DR
Practice Address - Street 2:SUITE 17
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1646
Practice Address - Country:US
Practice Address - Phone:314-842-6223
Practice Address - Fax:314-842-6124
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0011631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical