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General NPI Number Information
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NPI Number | 1750080735
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Entity Type | Individual
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Provider Name | ELIZABETH K STOOTHOFF LCPC-C
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Gender | Female
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 110 MAIN ST
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City | SACO
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State | ME
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Zip | 04072-3509
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Country | US
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Telephone | 207-200-7105
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Fax |
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Provider Business Mailing Address
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Address Line | 46 OAK RIDGE DR
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City | STANDISH
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State | ME
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Zip | 04084-6048
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Country | US
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Telephone | 207-671-1285
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | XL6998
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License Number State | ME
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