Mary Mantilla LCSW, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MARY MANTILLA LCSW, PLLC

Practice address

17 Stonehedge Dr
Poughkeepsie, NY 12603-6509

Phone

(845) 549-8223

NPI assigned

Nov 6, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Mary A Mantilla, LCSWRNPI 1609868439

Title

Clinician

Phone

(845) 549-8223

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Agnes Mantilla, LCSW

  • Clinical Social Worker
  • Poughkeepsie, NY
  • NPI 1609868439
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1427871664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 STONEHEDGE DR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036509",
            "telephone_number": "845-549-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 STONEHEDGE DR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036509",
            "telephone_number": "845-549-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY MANTILLA LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "MANTILLA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "845-549-8223",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSWR"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Martinko, M.D.
• Emily Rose Martinson, COTA
• Ellen J. Marx, PH.D.
• James Louis Marxer, NBC/HIS
• Mary Dyer MD PLLC
• Bruce D Marzullo, DDS
• John Mascia, MD
• Joan Masotti
• Marcia Masri
• Kristina Marie Massari, RN

• Community/Behavioral Health Agency in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Community/Behavioral Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.