Provider Demographics
NPI:1730795816
Name:MAHER, ELIZABETH ANNE (LMSW, CLINICAL)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:MAHER
Suffix:
Gender:F
Credentials:LMSW, CLINICAL
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:VOSKUIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1519 PONTIAC RD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-3367
Mailing Address - Country:US
Mailing Address - Phone:616-818-8481
Mailing Address - Fax:616-361-3492
Practice Address - Street 1:1519 PONTIAC RD SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-3367
Practice Address - Country:US
Practice Address - Phone:616-818-8481
Practice Address - Fax:616-361-3492
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010866811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty