Doctor Name: | KIRT WOODMAN |
NPI Number: | 1265517163 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | CC127 |
Business Practice Address: | 347 Depot St Wilton, ME - 042946655 |
Business Phone Number: | 2076459806 |
Business Fax Number: | |
Mailing Address: | 100 Hill Top Road, CHESTERVILLE |
State: | ME |
Postal Code: | 04938 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | CC127 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |