Provider Demographics
NPI:1821195645
Name:GOETZ, MARGARET (LICSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:GOETZ
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 1:16 FIFTH ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2950
Mailing Address - Country:US
Mailing Address - Phone:603-749-4462
Mailing Address - Fax:603-749-2475
Practice Address - Street 1:16 FIFTH ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2950
Practice Address - Country:US
Practice Address - Phone:603-749-4462
Practice Address - Fax:603-749-2475
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2079498OtherCIGNA
NH020258994-40OtherHARVARD PILGRIM
NH14Y001197NH02OtherBLUE CROSS
NH14Y001197NH02OtherBLUE CROSS