Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Brondou Dousharm, LCSW

Individual provider Clinical Social Worker · NPI 1356643514

Mary Brondou Dousharm, LCSW is a Clinical Social Worker in Gouverneur, New York. Qualified in 2010, 16 years ago. Practices with Gouverneur Hospital, a 31-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
16
Licensed in
NY
In the registry since
2010
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

28 William St
Gouverneur, NY 13642-1405
Phone: (315) 287-2811
Fax: (315) 394-0097
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 082898 (NY)

Record details

NPI number1356643514
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedNovember 22, 2010
Last updated in NPPESNovember 22, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Gouverneur Hospital — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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