Healthcare Provider Details

I. General information

NPI: 1194782466
Provider Name (Legal Business Name): MAUREEN MCARTHUR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 NO HWY 414
MOUNTAIN VIEW WY
82939
US

IV. Provider business mailing address

PO BOX 458 1050 NO HWY 414
MOUNTAIN VIEW WY
82939-0458
US

V. Phone/Fax

Practice location:
  • Phone: 307-782-3097
  • Fax:
Mailing address:
  • Phone: 307-782-3097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number57169563501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: