Fredricks, Mary Lavina
Fredricks, Mary Lavina is an sole proprietor health care provider with primary practice located at 38 Union St , Livermore Falls ME 04254. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Fredricks, Mary Lavina can be contacted via phone (207) 897-6601.Contact Information
Primary practice address
38 Union St
Livermore Falls ME 04254
Phone: (207) 897-6601
Fax: (207) 897-4339
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ME129365 | Maine |
Profile Details
| NPI number | 1376510412 |
|---|---|
| LBN Legal business name | Fredricks, Mary Lavina |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 8th, 2006 |
| Last updated | Nov 15th, 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 | 1376510412 | NPPES |
| Maine | MEDICAID | 218840099 | |
| Maine | Other | 047005 |
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