Provider Demographics
NPI:1154686244
Name:O'HANLON, MAUREEN (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:O'HANLON
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 SUMMERWALK RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-1432
Mailing Address - Country:US
Mailing Address - Phone:336-988-9988
Mailing Address - Fax:
Practice Address - Street 1:567 SUMMERWALK RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-1432
Practice Address - Country:US
Practice Address - Phone:336-988-9988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0076501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical