Provider Demographics
NPI:1639396369
Name:MCEACHEN, MAUREEN LYNN (LICSW)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:LYNN
Last Name:MCEACHEN
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 1:24843 OUTLOOK PL
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8935
Mailing Address - Country:US
Mailing Address - Phone:831-625-5257
Mailing Address - Fax:831-277-4546
Practice Address - Street 1:24843 OUTLOOK PL
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8935
Practice Address - Country:US
Practice Address - Phone:831-625-5257
Practice Address - Fax:831-277-4546
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC00302471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical