Provider Demographics
NPI:1720306285
Name:CORTS, MAUREEN ANNE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ANNE
Last Name:CORTS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:ANNE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3311 GREENLEAF BLVD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2516
Mailing Address - Country:US
Mailing Address - Phone:269-372-4140
Mailing Address - Fax:269-372-0390
Practice Address - Street 1:3311 GREENLEAF BLVD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-2516
Practice Address - Country:US
Practice Address - Phone:269-372-4140
Practice Address - Fax:269-372-0390
Is Sole Proprietor?:No
Enumeration Date:2010-05-08
Last Update Date:2017-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010666501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical