Healthcare Provider Details

I. General information

NPI: 1487662839
Provider Name (Legal Business Name): ANNE T HEMINWAY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 09/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 SEELY LN
PHIPPSBURG ME
04562-5208
US

IV. Provider business mailing address

51 SEELY LN
PHIPPSBURG ME
04562-5208
US

V. Phone/Fax

Practice location:
  • Phone: 207-798-2856
  • Fax:
Mailing address:
  • Phone: 207-798-2856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC5848
License Number StateME

VII. Legacy identifiers

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

# 1
Identifier277560099
Identifier TypeMEDICAID
Identifier StateME
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: