Provider Demographics
NPI:1124317631
Name:MAURO, JEAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:MAURO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:JEAN
Other - Last Name:ROE MAURO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 BRYANT CRESCENT
Mailing Address - Street 2:ONE LOWER K
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2637
Mailing Address - Country:US
Mailing Address - Phone:914-948-8408
Mailing Address - Fax:
Practice Address - Street 1:1 BRYANT CRESCENT
Practice Address - Street 2:ONE LOWER K.
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2637
Practice Address - Country:US
Practice Address - Phone:914-948-8408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR014467-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical