Provider Demographics
NPI:1205866084
Name:GERWITZ, MAUREEN DIANE (LCSWR)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:DIANE
Last Name:GERWITZ
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:DIANE
Other - Last Name:GERWITZ-HIRSCHFELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWR
Mailing Address - Street 1:525 WHEATFIELD ST
Mailing Address - Street 2:UNIT 58
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-7034
Mailing Address - Country:US
Mailing Address - Phone:716-949-5412
Mailing Address - Fax:716-535-1053
Practice Address - Street 1:525 WHEATFIELD ST
Practice Address - Street 2:UNIT 58
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-7034
Practice Address - Country:US
Practice Address - Phone:716-949-5412
Practice Address - Fax:716-535-1053
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0358181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00688211Medicaid
NY02774803Medicaid
NY000528348001OtherBC/BS OF WNY