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NPI Code Detail

MEDICARE: MS. MAUREEN CROSSEY LCSW

MEDICARE: MS. MAUREEN CROSSEY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker206328MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1206328OTHERMALCSW

General Provider Information

NPI Number : 1235292723
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAUREEN CROSSEY LCSW
Provider Business Mailing Address
First Line : 801 PLEASANT ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-3052
Country : US
Telephone Number : 508-586-9855
Fax Number : 508-583-5847
Provider Business Practice Location Address
First Line : 801 PLEASANT ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-3052
Country : US
Telephone Number : 508-586-9855
Fax Number : 508-583-5847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 07/08/2007

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