Provider Demographics
NPI:1295817674
Name:MAGALHAES, MARIA PENNA COSTA (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:PENNA COSTA
Last Name:MAGALHAES
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 1:17 JULIAN LANE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757
Mailing Address - Country:US
Mailing Address - Phone:508-478-4661
Mailing Address - Fax:508-879-1515
Practice Address - Street 1:5 EDGEL RD
Practice Address - Street 2:STE 24
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701
Practice Address - Country:US
Practice Address - Phone:508-879-7908
Practice Address - Fax:508-879-1515
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1120341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical