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General NPI Number Information
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NPI Number | 1437738358
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Entity Type | Individual
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Provider Name | GEMMA SARAH ATTICKS LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 22 BRAMHALL STREET
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City | PORTLAND
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State | ME
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Zip | 04102
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Country | US
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Telephone | 76-622-3572
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Fax | 207-662-4022
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Provider Business Mailing Address
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Address Line | 22 BRAMHALL ST
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City | PORTLAND
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State | ME
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Zip | 04102-3175
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Country | US
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Telephone | 207-662-2357
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Fax | 207-662-4022
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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 | LC18640
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License Number State | ME
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