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General NPI Number Information
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NPI Number | 1811903602
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Entity Type | Individual
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Provider Name | PATRICIA M. DESCHAMPS LMSW-CC
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 11/01/2012
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Provider Practice Location Address
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Address Line | 453 US ROUTE 1
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City | KITTERY
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State | ME
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Zip | 03904-5513
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Country | US
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Telephone | 207-451-1750
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Fax | 207-439-4360
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Provider Business Mailing Address
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Address Line | 78 ATLANTIC PL
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2316
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Country | US
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Telephone | 207-842-7701
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Fax | 207-842-7773
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | MC9079
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License Number State | ME
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