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NPI Code Detail

MEDICARE: MARIYA FYE LCSW

MEDICARE: MARIYA FYE 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
11041C0700XClinical Social Worker252370KY
2104100000XSocial Worker080428NY

General Provider Information

NPI Number : 1588960777
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIYA FYE LCSW
Provider Business Mailing Address
First Line : 104 REYNOLDS RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1177
Country : US
Telephone Number : 270-678-4801
Fax Number : 270-678-3866
Provider Business Practice Location Address
First Line : 104 REYNOLDS RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1177
Country : US
Telephone Number : 270-678-4801
Fax Number : 270-678-3866
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2011
Last Update Date : 01/31/2017

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