=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912658642
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARVI PANHWAR LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2022
-----------------------------------------------------
Last Update Date | 11/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 BAKER AVE STE 300
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01742-2124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-336-2731
-----------------------------------------------------
Fax | 833-336-2731
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 942 N MAIN ST
-----------------------------------------------------
City | BOERNE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78006-1628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-701-0310
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LICSW1142040
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 67226
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------