Provider Demographics
NPI:1669580643
Name:MCNAMARA, ANN LOFGREN (MSW LCSW)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:LOFGREN
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 MAMMOTH RD UNIT 4
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3254
Mailing Address - Country:US
Mailing Address - Phone:603-437-9488
Mailing Address - Fax:
Practice Address - Street 1:184 MAMMOTH RD UNIT 4
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3254
Practice Address - Country:US
Practice Address - Phone:603-437-9488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH401104100000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
1406570Y0NH03OtherANTHEM
1406570Y0NH03OtherANTHEM
RE4346Medicare ID - Type Unspecified