Provider Demographics
NPI:1194787903
Name:MONAGHAN, MARTHA ELIZABETH (MSW LCSW C)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:ELIZABETH
Last Name:MONAGHAN
Suffix:
Gender:F
Credentials:MSW LCSW C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:30 GREENWAY NW
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3557
Mailing Address - Country:US
Mailing Address - Phone:410-760-9079
Mailing Address - Fax:410-760-1121
Practice Address - Street 1:30 GREENWAY ST NW STE 5
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3557
Practice Address - Country:US
Practice Address - Phone:410-760-9079
Practice Address - Fax:410-760-1121
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD069611041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
10422720OtherCAQH
52674007OtherBS OF MD
001508OtherVALUE OPTIONS AND GREAT W
S003OtherBLUE SHIELD FEDERAL GROUP
0004OtherBLUE SHIELD FEDERAL
164652OtherMHN
5751523OtherAETNA BEHAVIORAL HEALTH
513268OtherNCPPO INNOVA MHIP
52674007OtherBLUE SHIELD OF MD
048056000OtherMAGELLAN BEHAVIORAL HEALT
100024224OtherAPS
164652OtherMHN AND TRICARE
345450OtherMAMSI UNITED HEALTH CARE
345450OtherMAMSI
345450OtherMAMSI UNITED HEALTH CARE
52674007OtherBLUE SHIELD OF MD