Provider Demographics
NPI:1548601719
Name:MCGINNIS LANE, MARIBARBARA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIBARBARA
Middle Name:
Last Name:MCGINNIS LANE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10572 HAREBELL RUN
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-9249
Mailing Address - Country:US
Mailing Address - Phone:720-220-4401
Mailing Address - Fax:201-939-3132
Practice Address - Street 1:8671 S QUEBEC ST STE 210
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-5861
Practice Address - Country:US
Practice Address - Phone:720-220-4401
Practice Address - Fax:201-939-3132
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9910801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical