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General NPI Number Information
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NPI Number | 1952438582
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Entity Type | Individual
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Provider Name | VIRGINIA E POND DBH, LCSW, CADC
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 401 PETER DANA POINT ROAD
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City | PRINCETON
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State | ME
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Zip | 04668-0466
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Country | US
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Telephone | 207-796-2321
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1274
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City | CALAIS
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State | ME
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Zip | 04619-6274
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CAC5229
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC10932
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License Number State | ME
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