Provider Demographics
NPI:1982786448
Name:V. GINNA MAUS LCSW PC
Entity type:Organization
Organization Name:V. GINNA MAUS LCSW PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GINNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINERVINI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-263-8948
Mailing Address - Street 1:231 N THIRD AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1423
Mailing Address - Country:US
Mailing Address - Phone:208-263-8948
Mailing Address - Fax:208-265-1779
Practice Address - Street 1:231 N THIRD AVE
Practice Address - Street 2:STE 201
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1423
Practice Address - Country:US
Practice Address - Phone:208-263-8948
Practice Address - Fax:208-265-1779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty