Healthcare Provider Details

I. General information

NPI: 1578850780
Provider Name (Legal Business Name): KATHERINE L SAWYER LCPC-C, LADC, CCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2011
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DELTA DR STE A
WESTBROOK ME
04092-4745
US

IV. Provider business mailing address

1 DELTA DR STE A
WESTBROOK ME
04092-4745
US

V. Phone/Fax

Practice location:
  • Phone: 207-856-7227
  • Fax: 207-856-2112
Mailing address:
  • Phone: 207-856-7227
  • Fax: 207-856-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC4474
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberXL3630
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: