Maurica E McDougale, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW022170 Issued in PA

Practice address

5913 Charles St
Philadelphia, PA 19135

Phone

(267) 974-7727

NPI assigned

Oct 3, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walnut Psychotherapy Center

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1659749497
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633219200000",
    "number": "1417629940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5913 CHARLES ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19135",
            "telephone_number": "267-974-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5913 CHARLES ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19135",
            "telephone_number": "267-974-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGALE",
        "first_name": "MAURICA",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-03",
        "last_updated": "2021-10-03",
        "certification_date": "2021-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea McDonough, PA-C
• Donna Lynne McDonough, CRNA
• Gregory L. McDonough
• Sara Lynn McDonough, CPNP-AC
• Vincent James McDonough, M.D.
• Amy McDougall
• Carey McDougall, M.S.
• Abby Grace McDowell
• Malinda McDuffie, MS
• Montinique Denice McEachern, PHD

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.