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NPI Code Detail

MEDICARE: MARTHA MARCHUT LCSW

MEDICARE:   MARTHA  MARCHUT  LCSW
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
11041C0700XClinical Social WorkerLC7394ME

Other Identifiers

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

General Provider Information

NPI Number : 1831288661
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA MARCHUT LCSW
Provider Business Mailing Address
First Line : 640 PLEASANT POINT RD
Second Line :
City : CUSHING
State : ME
Zip : 04563-3425
Country : US
Telephone Number : 207-354-0714
Fax Number :
Provider Business Practice Location Address
First Line : 640 PLEASANT POINT RD
Second Line :
City : CUSHING
State : ME
Zip : 04563-3425
Country : US
Telephone Number : 207-354-0714
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 02/28/2013

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Directions to “ MARTHA MARCHUT LCSW” Practice Location

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