Provider Demographics
NPI:1912051533
Name:LONSDALE, MARGARET ELIZABETH (MSW)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:LONSDALE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2459
Mailing Address - Country:US
Mailing Address - Phone:207-443-9113
Mailing Address - Fax:
Practice Address - Street 1:765 HIGH ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2459
Practice Address - Country:US
Practice Address - Phone:207-443-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC33751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME5894264OtherAETNA
ME010604OtherME BLUE SHIELD
MEMM3410Medicare ID - Type Unspecified