MEDICARE: MRS. MARY HELEN PRINGLE M.S.W., L.C.S.W.

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	0904002314	VA

General Provider Information

NPI Number	:	1831194570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY HELEN PRINGLE M.S.W., L.C.S.W.

Provider Business Mailing Address
First Line	:	4744 WINTERBERRY CT
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-7254
Country	:	US
Telephone Number	:	757-784-6057
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435A JOHN TYLER HWY
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-1457
Country	:	US
Telephone Number	:	757-784-6057
Fax Number	:

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

Provider Enumeration Date	:	06/18/2005
Last Update Date	:	07/08/2007

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