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General NPI Number Information
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NPI Number | 1053207134
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Entity Type | Individual
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Provider Name | ALEXANDRA KATHERINE MICHAUD LMSW-CC
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 32 COLLEGE AVE STE 304
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City | WATERVILLE
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State | ME
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Zip | 04901-6100
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Country | US
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Telephone | 207-992-0650
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Fax | 207-941-2955
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Provider Business Mailing Address
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Address Line | 700 MOUNT HOPE AVE STE 320
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City | BANGOR
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State | ME
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Zip | 04401-5680
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Country | US
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Telephone | 207-941-2952
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Fax | 207-941-2955
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | MC21293
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License Number State | ME
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