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General NPI Number Information
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NPI Number | 1902105497
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Entity Type | Individual
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Provider Name | ANNA LOCKE GOWDY LCPC, LADC
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Gender | Female
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 96 FALMOUTH ST
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City | PORTLAND
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State | ME
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Zip | 04103-4864
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Country | US
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Telephone | 207-780-4050
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Fax | 207-807-5749
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Provider Business Mailing Address
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Address Line | 389 CONGRESS ST ROOM 307
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City | PORTLAND
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State | ME
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Zip | 04101-3566
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Country | US
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Telephone | 207-874-8784
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Fax | 207-874-8913
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LC5248
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | XL3770
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CC4072
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License Number State | ME
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