Provider Demographics
NPI:1871245563
Name:VIDAL, MARGARET BEHAN (LMSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:BEHAN
Last Name:VIDAL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 HUBBARDS PATH
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-4948
Mailing Address - Country:US
Mailing Address - Phone:401-835-7366
Mailing Address - Fax:
Practice Address - Street 1:194 HUBBARDS PATH
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-4948
Practice Address - Country:US
Practice Address - Phone:401-835-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109496-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker