Provider Demographics
NPI:1700921848
Name:PAPPAS, MARY LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:LOUISE
Last Name:PAPPAS
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:PO BOX 1270
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06793-0270
Mailing Address - Country:US
Mailing Address - Phone:868-868-9084
Mailing Address - Fax:860-868-7263
Practice Address - Street 1:25 PARSONAGE LANE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06793
Practice Address - Country:US
Practice Address - Phone:860-868-9084
Practice Address - Fax:860-868-7299
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0063101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical