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General NPI Number Information
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NPI Number | 1053611426
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Entity Type | Individual
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Provider Name | ASHLEY LEEMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 609 FOREST AVE
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City | PORTLAND
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State | ME
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Zip | 04101-1515
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Country | US
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Telephone | 207-409-7895
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Fax |
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Provider Business Mailing Address
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Address Line | 124 CLEVELAND CIR
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-6713
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Country | US
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Telephone | 207-899-8584
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Fax |
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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 | MC12702
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC13752
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License Number State | ME
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