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

MS. Mary Ellen Summerville, LCSW

Individual provider Clinical Social Worker · NPI 1083058689

MS. Mary Ellen Summerville, LCSW is a Clinical Social Worker in White Plains, New York. Qualified in 1988, 38 years ago. Accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
38
Licensed in
NY
In the registry since
2013
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

39 N Broadway Frmh
White Plains, NY 10601-1602
Phone: (914) 684-6102
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence R039357-1 (NY)

Record details

NPI number1083058689
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedApril 25, 2013
Last updated in NPPESFebruary 3, 2014

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1988 (38 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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