Healthcare Provider Details
I. General information
NPI: 1386606846
Provider Name (Legal Business Name): LISA MARIE TORREY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/03/2006
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
682 WASHINGTON STREET
BATH ME
04530
US
IV. Provider business mailing address
682 WASHINGTON STREET
BATH ME
04530
US
V. Phone/Fax
- Phone: 207-442-0682
- Fax: 207-442-0680
- Phone: 207-442-0682
- Fax: 207-442-0680
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LC8207 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: