Provider Demographics
NPI:1790828994
Name:MCNAMARA, MARILYN J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:J
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CLOISTER COURT
Mailing Address - Street 2:STE. 100
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-990-1016
Mailing Address - Fax:
Practice Address - Street 1:111 CLOISTER COURT
Practice Address - Street 2:STE. 100
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-990-1016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCOO12021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
162436OtherVALUEOPTIONS
215288OtherMHN
165197000OtherMAGELLAN
2008275OtherCIGNA
205064OtherCOMPSYCH
NC57993OtherBCBS
60054OtherAETNA
264573OtherMAMSI
6221618OtherUNITED HEALTHCARE
264573OtherMAMSI
205064OtherCOMPSYCH