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General NPI Number Information
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NPI Number | 1174996185
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Entity Type | Individual
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Provider Name | ELISE C KIRKILAS LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 15 ANCHOR DR STE 202
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City | ROCKPORT
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State | ME
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Zip | 04856-3848
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Country | US
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Telephone | 207-301-5800
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Fax | 207-301-5332
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Provider Business Mailing Address
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Address Line | 15 ANCHOR DR STE 202
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City | ROCKPORT
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State | ME
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Zip | 04856-3848
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Country | US
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Telephone | 207-301-5800
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Fax | 207-301-5332
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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 | 2934
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License Number State | NH
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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 | CSW.09928668
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10098-123
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 169366
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License Number State | AK
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC21858
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License Number State | ME
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