Burns, Keith Wellman
Burns, Keith Wellman is an individual health care provider with primary practice located at 474 Main Street , Springvale ME 04083. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Burns, Keith Wellman can be contacted via phone (207) 324-1500.Contact Information
Primary practice address
474 Main Street
Springvale ME 04083
Phone: (207) 324-1500
Fax: (207) 490-5263
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LC7820 | Maine |
Profile Details
| NPI number | 1295846566 |
|---|---|
| LBN Legal business name | Burns, Keith Wellman |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Sep 24th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295846566 | NPPES |
| Maine | MEDICAID | 245780099 |
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