Provider Demographics
NPI:1609958537
Name:RING, MARY M (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:M
Last Name:RING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:M
Other - Last Name:PRINTZENHOFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:552 LINDEN AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2915
Mailing Address - Country:US
Mailing Address - Phone:716-652-8100
Mailing Address - Fax:716-655-6077
Practice Address - Street 1:552 LINDEN AVENUE
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2915
Practice Address - Country:US
Practice Address - Phone:716-652-8100
Practice Address - Fax:716-655-6077
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02695811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
6290119OtherINDEPENDENT HEALTH
000503885001OtherBLUE CROSS BLUE SHIELD
00026937001OtherUNIVERA
6290119OtherINDEPENDENT HEALTH
038851Medicare ID - Type Unspecified