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General NPI Number Information
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NPI Number | 1154254944
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Entity Type | Individual
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Provider Name | BAILEE OLIVIA PUTNAM LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 8 E MAIN ST
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City | WEST YARMOUTH
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State | MA
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Zip | 02673-8107
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Country | US
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Telephone | 508-296-5631
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Fax | 877-490-7647
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Provider Business Mailing Address
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Address Line | 136 ELM ST
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City | BANGOR
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State | ME
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Zip | 04401-4185
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Country | US
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Telephone | 508-296-5631
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Fax | 877-490-7647
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCSW2143749
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License Number State | MA
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