Healthcare Provider Details

I. General information

NPI: 1124468640
Provider Name (Legal Business Name): LAINE NOELLE PARSONS L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 12/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1093 W MAIN ST
DOVER FOXCROFT ME
04426-3717
US

IV. Provider business mailing address

244 STORER RD
BRADFORD ME
04410-3510
US

V. Phone/Fax

Practice location:
  • Phone: 207-802-3100
  • Fax: 207-564-3975
Mailing address:
  • Phone: 207-327-1402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC14265
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC15866
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC15866
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: