Provider Demographics
NPI:1447716451
Name:MCGUIRK, MARY ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANNE
Last Name:MCGUIRK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 WYLLIS AVE
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-7524
Mailing Address - Country:US
Mailing Address - Phone:781-417-2109
Mailing Address - Fax:781-268-5070
Practice Address - Street 1:37 FRIEND ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-3068
Practice Address - Country:US
Practice Address - Phone:781-417-2109
Practice Address - Fax:781-268-5070
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215222104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker