Healthcare Provider Details

I. General information

NPI: 1073673133
Provider Name (Legal Business Name): ARLAN HURD LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 STATE ST
BANGOR ME
04401-5112
US

IV. Provider business mailing address

6 STATE ST BANGOR
BANGOR ME
04401-5112
US

V. Phone/Fax

Practice location:
  • Phone: 207-992-2694
  • Fax: 207-992-2694
Mailing address:
  • Phone: 207-992-2694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLC4671
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: