Provider Demographics
NPI:1780852004
Name:OSHEA, MARY F (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:F
Last Name:OSHEA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 ANTHONY AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-4621
Mailing Address - Country:US
Mailing Address - Phone:631-567-8385
Mailing Address - Fax:631-567-8385
Practice Address - Street 1:2751 ANTHONY AVE
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-4621
Practice Address - Country:US
Practice Address - Phone:347-695-8004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047682-R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN9C-742Medicare UPIN