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General NPI Number Information
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NPI Number | 1144994161
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Entity Type | Individual
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Provider Name | MAMIE M FUTRELL LCSW, LISW-CP
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Gender | Female
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 02/26/2023
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Provider Practice Location Address
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Address Line | 955 FOREST ST
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City | DOVER
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State | DE
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Zip | 19904-3401
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Country | US
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Telephone | 302-760-9736
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Fax | 302-329-3107
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Provider Business Mailing Address
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Address Line | 217 BUCKEYE LN
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City | SMYRNA
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State | DE
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Zip | 19977-5246
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Country | US
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Telephone | 484-542-9883
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | Q1-0011940
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | Q1-0011940
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | Q1-0011940
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License Number State | DE
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