Provider Demographics
NPI:1356665699
Name:DEGAETANO, MARIA E (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:DEGAETANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:E
Other - Last Name:DEGAETANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:401 E LOUTHER ST STE 110
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-2657
Mailing Address - Country:US
Mailing Address - Phone:717-837-3367
Mailing Address - Fax:
Practice Address - Street 1:401 E LOUTHER ST STE 110
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-2657
Practice Address - Country:US
Practice Address - Phone:717-837-3367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0205621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical