Provider Demographics
NPI:1619955382
Name:MCGRATH, MARIANNE (LICSW)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:MCGRATH
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 1:161 FORBES RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-2606
Mailing Address - Country:US
Mailing Address - Phone:617-653-5492
Mailing Address - Fax:
Practice Address - Street 1:398 NEPONSET AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-3134
Practice Address - Country:US
Practice Address - Phone:617-282-3200
Practice Address - Fax:617-282-7928
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1048381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical