Provider Demographics
NPI:1326361080
Name:MAPLE, DENISE (LCSW / LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:MAPLE
Suffix:
Gender:F
Credentials:LCSW / LCSW-C
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:BELISLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW/LCSW-C
Mailing Address - Street 1:303 E GURLEY ST STE 472
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-3804
Mailing Address - Country:US
Mailing Address - Phone:928-925-1989
Mailing Address - Fax:
Practice Address - Street 1:339 S CORTEZ ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-4560
Practice Address - Country:US
Practice Address - Phone:928-925-1989
Practice Address - Fax:928-441-3077
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD130781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical