Healthcare Provider Details

I. General information

NPI: 1972685709
Provider Name (Legal Business Name): ROBIN PHAIR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 EUSTIS PKWY
WATERVILLE ME
04901-5173
US

IV. Provider business mailing address

30 HIGH ST
SKOWHEGAN ME
04976-1828
US

V. Phone/Fax

Practice location:
  • Phone: 207-660-4549
  • Fax: 207-660-4529
Mailing address:
  • Phone: 207-474-8368
  • Fax: 207-474-7794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC11828
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: