Healthcare Provider Details

I. General information

NPI: 1700047172
Provider Name (Legal Business Name): WHITNEY HODGKINS TAGGART LMSW-CC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 SPURWINK DR
CHELSEA ME
04330-1166
US

IV. Provider business mailing address

31 SPURWINK DR
CHELSEA ME
04330-1166
US

V. Phone/Fax

Practice location:
  • Phone: 207-582-7686
  • Fax: 207-582-7688
Mailing address:
  • Phone: 207-582-7686
  • Fax: 207-582-7688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC11616
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: