Provider Demographics
NPI:1073744678
Name:MAURIN, ADRIENNE B (LCSW)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:B
Last Name:MAURIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:BENEDETTO-MAURIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 2272
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-2272
Mailing Address - Country:US
Mailing Address - Phone:828-301-0770
Mailing Address - Fax:828-676-0495
Practice Address - Street 1:110 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-4543
Practice Address - Country:US
Practice Address - Phone:828-301-0770
Practice Address - Fax:828-692-7710
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA82241041C0700X
NCC0060671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6007391Medicaid
NC2853646OtherMEDICARE