Provider Demographics
NPI:1639585458
Name:MONGEAU, MAUREEN AHERN (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:AHERN
Last Name:MONGEAU
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MA
Mailing Address - Zip Code:01503-1630
Mailing Address - Country:US
Mailing Address - Phone:508-527-6200
Mailing Address - Fax:
Practice Address - Street 1:419 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-2153
Practice Address - Country:US
Practice Address - Phone:508-527-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health