Provider Demographics
NPI:1073734083
Name:FIORE, MAUREEN ANN (LSW)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:ANN
Last Name:FIORE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:ANN
Other - Last Name:HANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:197 WINONA ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-4658
Mailing Address - Country:US
Mailing Address - Phone:978-744-7037
Mailing Address - Fax:
Practice Address - Street 1:103 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4001
Practice Address - Country:US
Practice Address - Phone:781-593-2727
Practice Address - Fax:781-593-2542
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
MA2190271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist