Healthcare Provider Details

I. General information

NPI: 1225049075
Provider Name (Legal Business Name): APRIL RENEE CLOUTIER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 09/26/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 MCLAIN ROAD
LIBERTY ME
04949-3715
US

IV. Provider business mailing address

95 MCLAIN ROAD
LIBERTY ME
04949-3715
US

V. Phone/Fax

Practice location:
  • Phone: 207-837-7671
  • Fax: 207-798-3929
Mailing address:
  • Phone: 207-837-7671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC8501
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: