Victoria Grace Maurice

Individual provider Active NPI Clinical Social Worker · Village of Lakewood, IL

NPI 1437604253 · NPPES record last updated Aug 22, 2016

Key facts

NPI
1437604253
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
M62086796963 (IL)
Practice address
455 Huntley Rd
Village of Lakewood, IL 60014-5318
Phone
(847) 275-4171
NPI assigned
Aug 22, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
M62086796963ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X M62086796963 IL Yes

Addresses

Primary practice location

455 Huntley Rd
Village of Lakewood, IL 60014-5318

Mailing address

455 Huntley Rd
Village of Lakewood, IL 60014-5318
Phone (847) 275-4171

Other providers in Village of Lakewood, IL

All providers in Village of Lakewood, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.