Provider Demographics
NPI:1447454681
Name:HOPKINS, MAUREEN (LCSW-R)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NIAGARA ST
Mailing Address - Street 2:PO BOX 657
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-1503
Mailing Address - Country:US
Mailing Address - Phone:716-882-5959
Mailing Address - Fax:716-884-0602
Practice Address - Street 1:1300 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1503
Practice Address - Country:US
Practice Address - Phone:716-882-5959
Practice Address - Fax:716-884-0602
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR034064-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYTR800010856OtherTRAVERLERS
NYCC1232Medicare ID - Type Unspecified