MEDICARE: KAI CROWELL BRY

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	LC23546	ME

General Provider Information

NPI Number	:	1881439081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAI CROWELL BRY

Provider Business Mailing Address
First Line	:	7 RAILROAD AVE STE 317
Second Line	:
City	:	GORHAM
State	:	ME
Zip	:	04038-1546
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 CHRISTOPHER TOPPI DR
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-6901
Country	:	US
Telephone Number	:	207-808-8085
Fax Number	:

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

Provider Enumeration Date	:	06/28/2024
Last Update Date	:	02/14/2025

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Directions to “ KAI CROWELL BRY ” Practice Location

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