Provider Demographics
NPI:1174663454
Name:MAURER, MARGARET F (LCSW, CAC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:F
Last Name:MAURER
Suffix:
Gender:F
Credentials:LCSW, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W GROVE ST #3
Mailing Address - Street 2:BLDG 2 FL2
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2090
Mailing Address - Country:US
Mailing Address - Phone:570-357-5985
Mailing Address - Fax:570-587-5224
Practice Address - Street 1:301 W GROVE ST (BOX 3)
Practice Address - Street 2:BLDG 2, 2ND FL
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-2090
Practice Address - Country:US
Practice Address - Phone:570-357-5985
Practice Address - Fax:570-587-5224
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1720101YA0400X
PACW0133791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA046746JCOMedicare UPIN