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NPI Code Detail

MEDICARE: MICHAEL PATRICK MONAGHAN LICSW

MEDICARE:   MICHAEL PATRICK MONAGHAN  LICSW
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 Worker114690MA

General Provider Information

NPI Number : 1932679107
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL PATRICK MONAGHAN LICSW
Provider Business Mailing Address
First Line : 100 WHITING AVE
Second Line :
City : DEDHAM
State : MA
Zip : 02026-3114
Country : US
Telephone Number : 781-326-4773
Fax Number : 781-461-1638
Provider Business Practice Location Address
First Line : 100 WHITING AVE
Second Line :
City : DEDHAM
State : MA
Zip : 02026-3114
Country : US
Telephone Number : 781-326-4773
Fax Number : 781-461-1638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2018
Last Update Date : 03/22/2026

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Directions to “ MICHAEL PATRICK MONAGHAN LICSW” Practice Location

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