Healthcare Provider Details

I. General information

NPI: 1972720639
Provider Name (Legal Business Name): RICHARD SCHAMLE LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FERNALD POINT RD
SOUTHWEST HARBOR ME
04679-4614
US

IV. Provider business mailing address

PO BOX 180
EAST ORLAND ME
04431-0180
US

V. Phone/Fax

Practice location:
  • Phone: 207-244-4012
  • Fax: 207-244-4013
Mailing address:
  • Phone: 207-469-6565
  • Fax: 207-244-4013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC5284
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: