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General NPI Number Information
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NPI Number | 1851476220
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Entity Type | Individual
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Provider Name | MARY ELLEN MCLEAN M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 48 BRIDGE ST
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City | SALEM
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State | MA
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Zip | 01970-4127
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Country | US
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Telephone | 978-744-7905
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Fax | 978-740-9145
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Provider Business Mailing Address
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Address Line | 66 LEE ST APT. 2
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City | MARBLEHEAD
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State | MA
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Zip | 01945-3253
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Country | US
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Telephone | 781-639-8579
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2026079
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License Number State | MA
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