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General NPI Number Information
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NPI Number | 1225663883
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Entity Type | Organization
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Legal Business Name | STEPHANIE ROSE TRANCHEMONTAGNE, LCSW LLC
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 95 INDIA ST
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City | PORTLAND
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State | ME
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Zip | 04101-4250
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Country | US
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Telephone | 207-502-5090
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Fax |
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Provider Business Mailing Address
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Address Line | 23 HALEY RD
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City | ARUNDEL
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State | ME
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Zip | 04046-7975
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Country | US
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Telephone | 207-502-5090
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | STEPHANIE R TRANCHEMONTAGNE
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Credential | LCSW LLC
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Telephone | 207-502-5090
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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 |
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License Number State |
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