Healthcare Provider Details

I. General information

NPI: 1568426229
Provider Name (Legal Business Name): MARY ELLEN KAUFFMAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STUTTGART SWS UNIT 30401
APO AE
09107
DE

IV. Provider business mailing address

CMR 445
APO AE
09046
DE

V. Phone/Fax

Practice location:
  • Phone: 497031152676
  • Fax: 497031152967
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCWO14779
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: