Provider Demographics
NPI:1568871606
Name:FINE, MAURA (LICSW)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:
Last Name:FINE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:16 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2930
Mailing Address - Country:US
Mailing Address - Phone:603-785-0130
Mailing Address - Fax:
Practice Address - Street 1:16 5TH ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2930
Practice Address - Country:US
Practice Address - Phone:603-785-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH26191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical