MEDICARE: MARIAN HOWARD LCSWR

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
1	1041C0700X	Clinical Social Worker	R030135	NY

General Provider Information

NPI Number	:	1821463878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAN HOWARD LCSWR

Provider Business Mailing Address
First Line	:	4C HOLLAND DR
Second Line	:
City	:	WEST HURLEY
State	:	NY
Zip	:	12491-5615
Country	:	US
Telephone Number	:	845-338-3885
Fax Number	:

Provider Business Practice Location Address
First Line	:	666 AARON CT
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-2968
Country	:	US
Telephone Number	:	845-338-3885
Fax Number	:	845-728-0667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2015
Last Update Date	:	04/09/2018

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