Provider Demographics
NPI:1902938566
Name:MARHEWKA, GAIL ELIZABETH (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:ELIZABETH
Last Name:MARHEWKA
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MARKET ST
Mailing Address - Street 2:#14
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3998
Mailing Address - Country:US
Mailing Address - Phone:508-379-0150
Mailing Address - Fax:508-379-1112
Practice Address - Street 1:25 MARKET ST
Practice Address - Street 2:#14
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3998
Practice Address - Country:US
Practice Address - Phone:508-379-0150
Practice Address - Fax:508-379-1112
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1066441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA795496OtherTUFTS HEALTH PLAN
MAP05227OtherBLUE CROSS BLUE SHIELD
MAP05227Medicare PIN
MAP05227OtherBLUE CROSS BLUE SHIELD