Doctor Name: | MS. MICHAELE J POTVIN |
NPI Number: | 1205066636 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LC12630 |
Business Practice Address: | 193 Main Street Suite 9 Norway, ME - 04268 |
Business Phone Number: | 2077438766 |
Business Fax Number: | 2077431579 |
Mailing Address: | 301c Us Route 1, SCARBOROUGH |
State: | ME |
Postal Code: | 040749701 |
Phone Number: | 2073968600 |
Fax Number: | 2073968632 |
NPI Enumeration Date: | 07/20/2009 |
NPI Last Update Date: | 04/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LC12630 |
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 |