MEDICARE: MRS. ELAINE MARIE MAHER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	61370884	WA
2	1041C0700X	Clinical Social Worker	3207	HI
3	1041C0700X	Clinical Social Worker	LC24311	ME
4	1041C0700X	Clinical Social Worker	LCSW-17658	AZ

General Provider Information

NPI Number	:	1629055975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELAINE MARIE MAHER LCSW

Provider Business Mailing Address
First Line	:	1740 S DESERT VISTA DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85748-7503
Country	:	US
Telephone Number	:	808-551-2251
Fax Number	:

Provider Business Practice Location Address
First Line	:	1740 S DESERT VISTA DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85748-7503
Country	:	US
Telephone Number	:	808-551-2251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	02/14/2025

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