Healthcare Provider Details

I. General information

NPI: 1154005155
Provider Name (Legal Business Name): ALESSANDRA M FORSTHOEFEL LMSW-CC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALESSANDRA M FRANK

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 BARIBEAU DR
BRUNSWICK ME
04011-3230
US

IV. Provider business mailing address

66 BARIBEAU DR
BRUNSWICK ME
04011-3230
US

V. Phone/Fax

Practice location:
  • Phone: 207-373-6950
  • Fax: 207-373-6959
Mailing address:
  • Phone: 207-373-6950
  • Fax: 207-373-6959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC22433
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: