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Individual
MRS. MARIBETH COUGHLIN
Active
Individual
MRS. MARIBETH COUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1024551
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081218
VALUE OPTIONS PROVIDER NU
MA
01
—
6200034
EVERCARE PROVIDER NUMBER
MD
01
—
P07016
BCBS PROVIDER NUMBER
MA
Enumeration date
10/16/2006
Last updated
07/08/2007
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