Provider Demographics
NPI:1578604815
Name:MAHER, JAMES HARRIS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HARRIS
Last Name:MAHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:440 S. SECOND STREET
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-2854
Mailing Address - Country:US
Mailing Address - Phone:760-256-7966
Mailing Address - Fax:760-818-4639
Practice Address - Street 1:440 S. SECOND STREET
Practice Address - Street 2:STE 105
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-2854
Practice Address - Country:US
Practice Address - Phone:760-256-7966
Practice Address - Fax:760-818-4639
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 14603101YM0800X
CALCSW285151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health