Healthcare Provider Details

I. General information

NPI: 1790994747
Provider Name (Legal Business Name): MAUREEN HANDLIN CORRIGAN MSW,LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 ROUTE 149
MARSTONS MILLS MA
02648
US

IV. Provider business mailing address

P.O. BOX 1201
EAST DENNIS MA
02641
US

V. Phone/Fax

Practice location:
  • Phone: 508-362-1511
  • Fax: 508-362-1511
Mailing address:
  • Phone: 508-237-3602
  • Fax: 508-362-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number106463
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: