Doctor Name: | CARLISLE E. BLIND |
NPI Number: | 1154601532 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LC14210 |
Business Practice Address: | 12 Westbrook Common Westbrook, ME - 040922819 |
Business Phone Number: | 2078561500 |
Business Fax Number: | 2078561518 |
Mailing Address: | 78 Atlantic Place, SOUTH PORTLAND |
State: | ME |
Postal Code: | 041062316 |
Phone Number: | 2076616654 |
Fax Number: | 2078427773 |
NPI Enumeration Date: | 08/17/2011 |
NPI Last Update Date: | 03/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LC14210 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |