Healthcare Provider Details

I. General information

NPI: 1902850589
Provider Name (Legal Business Name): LONGVIEW PSYCHOTHERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 WASHINGTON AVE SUITE 304
PORTLAND ME
04103-3636
US

IV. Provider business mailing address

1321 WASHINGTON AVE SUITE 304
PORTLAND ME
04103-3636
US

V. Phone/Fax

Practice location:
  • Phone: 207-541-9364
  • Fax: 888-765-8406
Mailing address:
  • Phone: 207-541-9364
  • Fax: 888-765-8406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC3829
License Number StateME

VIII. Authorized Official

Name: PAULA CURRAN
Title or Position: PRESIDENT
Credential: LCSW
Phone: 207-541-9364