Provider Demographics
NPI:1275687915
Name:ROIANOV, MAUREEN JOYCE (LICSW)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:JOYCE
Last Name:ROIANOV
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 ELIGO LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HARDWICK
Mailing Address - State:VT
Mailing Address - Zip Code:05843
Mailing Address - Country:US
Mailing Address - Phone:603-823-7419
Mailing Address - Fax:603-823-7419
Practice Address - Street 1:461 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANCONIA
Practice Address - State:NH
Practice Address - Zip Code:03580-4835
Practice Address - Country:US
Practice Address - Phone:603-823-7419
Practice Address - Fax:603-823-7419
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9901041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30422531Medicaid
NH30422531Medicaid