Provider Demographics
NPI:1396753539
Name:MOSCARITOLO, MARIA STEWART (LICSW)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:STEWART
Last Name:MOSCARITOLO
Suffix:
Gender:F
Credentials:LICSW
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 650
Mailing Address - Street 2:
Mailing Address - City:CATAUMET
Mailing Address - State:MA
Mailing Address - Zip Code:02534-0650
Mailing Address - Country:US
Mailing Address - Phone:508-563-5763
Mailing Address - Fax:
Practice Address - Street 1:63 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-1455
Practice Address - Country:US
Practice Address - Phone:508-697-9722
Practice Address - Fax:508-279-0094
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10282721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA425698OtherHARVARD/PILGRIM
MAP07321OtherBLUE CROSS
MA425698OtherHARVARD/PILGRIM