=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750634895
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DEBBIE PAPPS LCSW LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2012
-----------------------------------------------------
Last Update Date | 10/05/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 LINCOLN ST STE 217
-----------------------------------------------------
City | SACO
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04072-3113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-807-3112
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 138 BELFORT ST
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04103-1219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-807-3112
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DEBRA PAPPS
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 207-807-3112
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LC6344
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------