Provider Demographics
NPI:1902389034
Name:MARAMARCO, MICHELLE L (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:MARAMARCO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:PEREIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 NEPONSET ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-368-5532
Mailing Address - Fax:
Practice Address - Street 1:225 NEW LANCASTER ROAD
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-4958
Practice Address - Country:US
Practice Address - Phone:617-849-7113
Practice Address - Fax:617-849-7113
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2187041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical