Provider Demographics
NPI:1992338834
Name:MAGUIRE, MARIE VERONICA (PA LCSW)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:VERONICA
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:PA LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 WALTON RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2301
Mailing Address - Country:US
Mailing Address - Phone:610-940-4430
Mailing Address - Fax:610-940-4432
Practice Address - Street 1:1730 WALTON RD STE 201
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2301
Practice Address - Country:US
Practice Address - Phone:610-940-4430
Practice Address - Fax:610-940-4432
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0127171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical