Provider Demographics
NPI:1841415825
Name:TASHJIAN, MAUREEN LYONS (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:LYONS
Last Name:TASHJIAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 MAPLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1407
Mailing Address - Country:US
Mailing Address - Phone:215-932-7330
Mailing Address - Fax:215-750-7454
Practice Address - Street 1:509 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5512
Practice Address - Country:US
Practice Address - Phone:215-860-1062
Practice Address - Fax:215-860-1062
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-0146121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7113517OtherAETNA PROVIDER NUMBER