MEDICARE: MS. LILIAM B STETTNER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R0337911	NY

General Provider Information

NPI Number	:	1790972172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LILIAM B STETTNER LCSW

Provider Business Mailing Address
First Line	:	PO BOX 19
Second Line	:
City	:	WHITE SULPHUR SPRINGS
State	:	NY
Zip	:	12787
Country	:	US
Telephone Number	:	845-292-5209
Fax Number	:	845-292-1210

Provider Business Practice Location Address
First Line	:	538 WILLI HILL RD
Second Line	:
City	:	WHITE SULPHUR SPRINGS
State	:	NY
Zip	:	12787
Country	:	US
Telephone Number	:	845-292-5209
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2007
Last Update Date	:	09/28/2007

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