Mary Patric, LCSW

Individual provider Active NPI Clinical Social Worker · Holloman Afb, NM

NPI 1306996624 · NPPES record last updated Apr 17, 2025

Key facts

NPI
1306996624
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LC5852 (ME)
Practice address
280 David L Goldfein St BLDG 23
Holloman Afb, NM 88330-8273
Phone
(575) 800-4205
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Aroostook Mental Health Services, Inc. Social Worker Past
since Nov 12, 1999
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC5852 ME Yes

Addresses

Primary practice location

280 David L Goldfein St BLDG 23
Holloman Afb, NM 88330-8273

Mailing address

280 David L Goldfein St BLDG 23
Holloman Afb, NM 88330-8273
Phone (575) 430-3437

Other providers in Holloman Afb, NM

All providers in Holloman Afb, NM · Clinical Social Worker in New Mexico

Sources for this page

Verify at the official NPI Registry.