Provider Demographics
NPI:1134476781
Name:MABERRY, ANNE LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:LOUISE
Last Name:MABERRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4532 MARVIN DR
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-5331
Mailing Address - Country:US
Mailing Address - Phone:610-966-3246
Mailing Address - Fax:
Practice Address - Street 1:1405 N CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2308
Practice Address - Country:US
Practice Address - Phone:610-435-4151
Practice Address - Fax:610-435-3044
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0191291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical