Healthcare Provider Details

I. General information

NPI: 1205866084
Provider Name (Legal Business Name): MAUREEN DIANE GERWITZ LCSWR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAUREEN DIANE GERWITZ-HIRSCHFELT LCSWR

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 05/29/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 WHEATFIELD ST UNIT 58
NORTH TONAWANDA NY
14120-7034
US

IV. Provider business mailing address

525 WHEATFIELD ST UNIT 58
NORTH TONAWANDA NY
14120-7034
US

V. Phone/Fax

Practice location:
  • Phone: 716-949-5412
  • Fax: 716-535-1053
Mailing address:
  • Phone: 716-949-5412
  • Fax: 716-535-1053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number035818
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: