Provider Demographics
NPI:1922342716
Name:PETERS, MAUREEN (ACSW,LCSW, ACHP-SW)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:ACSW,LCSW, ACHP-SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14445 87TH AVE
Mailing Address - Street 2:SILVERCREST ECF
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3109
Mailing Address - Country:US
Mailing Address - Phone:718-480-4034
Mailing Address - Fax:718-480-4028
Practice Address - Street 1:14445 87TH AVE
Practice Address - Street 2:SILVERCREST ECF
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-3109
Practice Address - Country:US
Practice Address - Phone:718-480-4034
Practice Address - Fax:718-480-4028
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075358-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical