Provider Demographics
NPI:1669554143
Name:MAHER, TERRENCE KEVIN (LCSW)
Entity type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:KEVIN
Last Name:MAHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12 FULMAR LN
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1709
Mailing Address - Country:US
Mailing Address - Phone:714-376-3574
Mailing Address - Fax:714-704-8806
Practice Address - Street 1:800 N ECKHOFF ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1008
Practice Address - Country:US
Practice Address - Phone:714-704-8814
Practice Address - Fax:714-704-8806
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW272381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical