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General NPI Number Information
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NPI Number | 1871456293
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Entity Type | Individual
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Provider Name | LARA ANDERSON LMSWCC
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Gender | Female
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 96 LINCOLN ST
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City | PORTLAND
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State | ME
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Zip | 04103-4052
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Country | US
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Telephone | 207-841-5902
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Fax |
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Provider Business Mailing Address
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Address Line | 96 LINCOLN ST APT 3
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City | PORTLAND
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State | ME
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Zip | 04103-4052
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Country | US
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Telephone |
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | MC24955
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License Number State | ME
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