MEDICARE: CATHARINE DELAPORTE PAYSON MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LC4439	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073730404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHARINE DELAPORTE PAYSON MSW

Provider Business Mailing Address
First Line	:	43 COTTAGE FARMS ROAD
Second Line	:
City	:	CAPE ELIZABETH
State	:	ME
Zip	:	04107
Country	:	US
Telephone Number	:	207-615-1854
Fax Number	:

Provider Business Practice Location Address
First Line	:	585 FOREST AVE
Second Line	:	STE 1
City	:	PORTLAND
State	:	ME
Zip	:	04101-1519
Country	:	US
Telephone Number	:	207-615-1854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	02/22/2019

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