Provider Demographics
NPI:1598047938
Name:CONCEPCION, MARIA (LMSW)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:CONCEPCION
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 MAPLE AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-1331
Mailing Address - Country:US
Mailing Address - Phone:973-919-9796
Mailing Address - Fax:973-473-2380
Practice Address - Street 1:283 MAPLE AVE FL 1
Practice Address - Street 2:
Practice Address - City:WALLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07057-1331
Practice Address - Country:US
Practice Address - Phone:973-919-9796
Practice Address - Fax:973-473-2380
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051312104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker