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NPI Code Detail

MEDICARE: ALLISON JOY HEIDORN LMSW-CC

MEDICARE: ALLISON JOY HEIDORN LMSW-CC
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
1104100000XSocial WorkerMC24924ME

General Provider Information

NPI Number : 1396695748
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON JOY HEIDORN LMSW-CC
Provider Business Mailing Address
First Line : 28 STATE ST STE 5
Second Line :
City : GORHAM
State : ME
Zip : 04038-1147
Country : US
Telephone Number : 207-222-0299
Fax Number :
Provider Business Practice Location Address
First Line : 28 STATE ST STE 5
Second Line :
City : GORHAM
State : ME
Zip : 04038-1147
Country : US
Telephone Number : 207-222-0299
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ ALLISON JOY HEIDORN LMSW-CC” Practice Location

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