Provider Demographics
NPI:1932332095
Name:UNDERWOOD, MARGARET WAGNER (LCPC)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:WAGNER
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5557 URBANA PIKE # 1109
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7277
Mailing Address - Country:US
Mailing Address - Phone:303-564-8641
Mailing Address - Fax:
Practice Address - Street 1:5557 URBANA PIKE # 1109
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-7277
Practice Address - Country:US
Practice Address - Phone:240-712-4215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2025-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5740101YP2500X
CO5123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO101YP2500XMedicaid