Provider Demographics
NPI:1861474959
Name:BOST, MARGARET LILLIAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:LILLIAN
Last Name:BOST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:KLOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 DEERHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-2718
Mailing Address - Country:US
Mailing Address - Phone:201-785-0604
Mailing Address - Fax:201-785-0604
Practice Address - Street 1:121 DEERHAVEN RD
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-2718
Practice Address - Country:US
Practice Address - Phone:201-785-0604
Practice Address - Fax:201-785-0604
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC036851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ161250Medicare PIN