Individual provider · Type 1 NPI
Mary B. Ezequelle, LCSW, PC
Clinical Social Worker · Gypsum, CO
Practice location
262 Cedar Dr, Box 4066
Gypsum, CO 81637-4066
Fax (970) 524-2025
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | 991906 (CO) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
About NPI 1700116845
Mary B. Ezequelle, LCSW, PC's National Provider Identifier is 1700116845, issued on Jan 13, 2010. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Gypsum, CO. The record was last updated on Jan 13, 2010.