Basic Information
| Provider Information | |||||||||
| NPI: | 1659680833 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAD 6 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BAR MILLS | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040040038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078923233 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BAR MILLS | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040040038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078923233 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2010 | ||||||||
| LastUpdateDate: | 10/05/2010 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | LOIGNON | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | SOCIAL WORKER | ||||||||
| AuthorizedOfficialTelephone: | 2078923233 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041S0200X | LC11023 | ME | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.