Provider Demographics
NPI:1356923114
Name:MONROE, MAXINE J (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MAXINE
Middle Name:J
Last Name:MONROE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2963
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-0199
Mailing Address - Country:US
Mailing Address - Phone:845-489-7483
Mailing Address - Fax:
Practice Address - Street 1:276 TEMPLE HILL RD UNIT 105
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6845
Practice Address - Country:US
Practice Address - Phone:845-489-7483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075968104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker