Provider Demographics
NPI:1366898850
Name:FAHEY, MAUREEN ELIZBETH (BA)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ELIZBETH
Last Name:FAHEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:ELIZABETH
Other - Last Name:MCAULIFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:114 RIVERBANK
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-1312
Mailing Address - Country:US
Mailing Address - Phone:609-386-8653
Mailing Address - Fax:609-386-3153
Practice Address - Street 1:114 RIVERBANK
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-1312
Practice Address - Country:US
Practice Address - Phone:609-386-8653
Practice Address - Fax:609-386-3153
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker