Provider Demographics
NPI:1255588646
Name:HERNANDES, MAUREEN MURPHY (LCSW-R)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:MURPHY
Last Name:HERNANDES
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:MURPHY
Other - Last Name:HERNANDES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:144 LIME RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:POUGHQUAG
Mailing Address - State:NY
Mailing Address - Zip Code:12570-5422
Mailing Address - Country:US
Mailing Address - Phone:845-489-2651
Mailing Address - Fax:485-489-2651
Practice Address - Street 1:144 LIMERIDGE ROAD
Practice Address - Street 2:
Practice Address - City:POUGHQUAG
Practice Address - State:NY
Practice Address - Zip Code:12570-1328
Practice Address - Country:US
Practice Address - Phone:845-489-2651
Practice Address - Fax:485-489-2651
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0696551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical