Healthcare Provider Details

I. General information

NPI: 1801004700
Provider Name (Legal Business Name): CATHERINE A. MORSE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 11/24/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 PIERCES POND RD
PENOBSCOT ME
04476-3812
US

IV. Provider business mailing address

PO BOX 84
PENOBSCOT ME
04476-0084
US

V. Phone/Fax

Practice location:
  • Phone: 207-469-5176
  • Fax:
Mailing address:
  • Phone: 207-469-5176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC2162
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier236370099
Identifier TypeMEDICAID
Identifier StateME
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: