Healthcare Provider Details

I. General information

NPI: 1407721509
Provider Name (Legal Business Name): CAROL LEE OEHLSCHLAGER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 LAKEVIEW DR
NORTH WATERBORO ME
04061-4787
US

IV. Provider business mailing address

25 JUNE ST
SANFORD ME
04073-2621
US

V. Phone/Fax

Practice location:
  • Phone: 207-415-4596
  • Fax:
Mailing address:
  • Phone: 207-490-7637
  • Fax: 207-490-7838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC24915
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: