Healthcare Provider Details

I. General information

NPI: 1891740759
Provider Name (Legal Business Name): MARYBETH JOYCE-MAURICE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

284 MAIN ST SUITE 320
SCHOHARIE NY
12157-2118
US

IV. Provider business mailing address

284 MAIN ST SUITE 320
SCHOHARIE NY
12157-2118
US

V. Phone/Fax

Practice location:
  • Phone: 518-295-8336
  • Fax: 518-295-8724
Mailing address:
  • Phone: 518-295-8336
  • Fax: 518-295-8724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number069933
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: