Provider Demographics
NPI:1477190403
Name:ALDEN, MAGDA (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:MAGDA
Middle Name:
Last Name:ALDEN
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7171
Mailing Address - Country:US
Mailing Address - Phone:207-396-7788
Mailing Address - Fax:207-396-8500
Practice Address - Street 1:100 CAMPUS DR UNIT 121
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7172
Practice Address - Country:US
Practice Address - Phone:207-396-7788
Practice Address - Fax:207-396-8500
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC144031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical