Provider Demographics
NPI:1992003156
Name:HEBERT, MAUREEN O (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:O
Last Name:HEBERT
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 1:50 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-2104
Mailing Address - Country:US
Mailing Address - Phone:401-368-5123
Mailing Address - Fax:
Practice Address - Street 1:50 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:RI
Practice Address - Zip Code:02885-2104
Practice Address - Country:US
Practice Address - Phone:401-368-5123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW005751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical