Provider Demographics
NPI:1962896704
Name:ESTY, MARY LEE (PHD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:LEE
Last Name:ESTY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 WILLARD AVE
Mailing Address - Street 2:APT. 1035
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4643
Mailing Address - Country:US
Mailing Address - Phone:301-215-7721
Mailing Address - Fax:301-215-7718
Practice Address - Street 1:7910 WOODMONT AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3002
Practice Address - Country:US
Practice Address - Phone:301-215-7721
Practice Address - Fax:301-215-7718
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD059131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical