Provider Demographics
NPI:1912629072
Name:VAN NES, MAGGIE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:
Last Name:VAN NES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:ACORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:11754 JOLLYVILLE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3948
Mailing Address - Country:US
Mailing Address - Phone:866-912-2746
Mailing Address - Fax:800-420-2305
Practice Address - Street 1:11754 JOLLYVILLE RD STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3948
Practice Address - Country:US
Practice Address - Phone:866-912-2746
Practice Address - Fax:800-420-2305
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108352104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker