MEDICARE: MS. MARGARET MARY ANZALONE LICSW, LMFT

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	1023484	MA
2	1041C0700X	Clinical Social Worker	LC16304	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LC16304	OTHER	ME	MAINE CLINICAL SOCIAL WORK LICENSE

General Provider Information

NPI Number	:	1932154234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET MARY ANZALONE LICSW, LMFT

Provider Business Mailing Address
First Line	:	435 CUSHMAN RD
Second Line	:
City	:	WINSLOW
State	:	ME
Zip	:	04901-0751
Country	:	US
Telephone Number	:	978-314-4763
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 CUSHMAN RD
Second Line	:
City	:	WINSLOW
State	:	ME
Zip	:	04901-0751
Country	:	US
Telephone Number	:	978-314-4763
Fax Number	:

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/12/2022

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