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General NPI Number Information
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NPI Number | 1386732899
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Entity Type | Individual
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Provider Name | MAUREEN FRANCES HICKERSON-MCKEON LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 421 COOLIDGE DRIVE
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City | CENTERPORT
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State | NY
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Zip | 11721-1205
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Country | US
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Telephone | 516-922-0261
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Fax | 516-922-0261
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Provider Business Mailing Address
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Address Line | 421 COOLIDGE DRIVE
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City | CENTERPORT
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State | NY
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Zip | 11721-1205
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Country | US
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Telephone | 516-922-0261
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Fax | 516-922-0261
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R039609-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R-039609-0
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License Number State | NY
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