Provider Demographics
NPI:1083773287
Name:POLIKOFF, MAUREEN ONEAL (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:ONEAL
Last Name:POLIKOFF
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 PHOENIX AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1059
Mailing Address - Country:US
Mailing Address - Phone:505-345-1262
Mailing Address - Fax:505-345-1262
Practice Address - Street 1:4233 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE 200-W
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6749
Practice Address - Country:US
Practice Address - Phone:505-321-8506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-32141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical