Provider Demographics
NPI:1821144122
Name:MAGERMAN, MARK HOWARD (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:HOWARD
Last Name:MAGERMAN
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2499 AQUETONG RD
Mailing Address - Street 2:P.O. BOX 74
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-5737
Mailing Address - Country:US
Mailing Address - Phone:215-860-9876
Mailing Address - Fax:
Practice Address - Street 1:1703 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 6
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1082
Practice Address - Country:US
Practice Address - Phone:215-860-9876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0133131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical