Provider Demographics
NPI:1588809297
Name:GASWIRTH, MAURA KENNEDY (LICSW)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:KENNEDY
Last Name:GASWIRTH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 PATRICIA ROBERTS HARRIS PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1636
Mailing Address - Country:US
Mailing Address - Phone:202-680-2482
Mailing Address - Fax:202-727-6632
Practice Address - Street 1:2507 PATRICIA ROBERTS HARRIS PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1636
Practice Address - Country:US
Practice Address - Phone:202-680-2482
Practice Address - Fax:202-727-6632
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500785571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical