Healthcare Provider Details

I. General information

NPI: 1972208742
Provider Name (Legal Business Name): AMY L WOODMAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 S PATTEN RD
PATTEN ME
04765-3007
US

IV. Provider business mailing address

PO BOX 513
LINCOLN ME
04457-0513
US

V. Phone/Fax

Practice location:
  • Phone: 207-538-3700
  • Fax:
Mailing address:
  • Phone: 207-794-4417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC22442
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLS14359
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberLS14359
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: