Provider Demographics
NPI:1801191689
Name:MAHLIK, MARGARET LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:LEE
Last Name:MAHLIK
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 1:19220 MCLOUGHLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027-2642
Mailing Address - Country:US
Mailing Address - Phone:503-655-2404
Mailing Address - Fax:503-655-1581
Practice Address - Street 1:19220 MCLOUGHLIN BLVD
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027
Practice Address - Country:US
Practice Address - Phone:503-655-2404
Practice Address - Fax:503-655-1581
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
ORL43151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR022959Medicaid
OR093511Medicaid
OR022959Medicaid