Provider Demographics
NPI:1023232865
Name:MAGUIRE, ELISABETH (LICSW)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ELISABETH
Other - Middle Name:
Other - Last Name:MAGUIRE LARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 DANIEL WEBSTER HWY # 895
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5224
Mailing Address - Country:US
Mailing Address - Phone:603-318-2920
Mailing Address - Fax:
Practice Address - Street 1:131 DANIEL WEBSTER HWY # 895
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5224
Practice Address - Country:US
Practice Address - Phone:603-318-2920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1149781041C0700X
NH17681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3100491Medicaid