Provider Demographics
NPI:1932154234
Name:ANZALONE, MARGARET MARY (LICSW, LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:MARY
Last Name:ANZALONE
Suffix:
Gender:F
Credentials:LICSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 CUSHMAN RD
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-0751
Mailing Address - Country:US
Mailing Address - Phone:978-314-4763
Mailing Address - Fax:
Practice Address - Street 1:435 CUSHMAN RD
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:ME
Practice Address - Zip Code:04901-0751
Practice Address - Country:US
Practice Address - Phone:978-314-4763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10234841041C0700X
MELC163041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MELC16304OtherMAINE CLINICAL SOCIAL WORK LICENSE