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NPI Code Detail

MEDICARE: KERI ROTHERMEL LCSW

MEDICARE: KERI ROTHERMEL LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLC8610ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285691428
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERI ROTHERMEL LCSW
Provider Business Mailing Address
First Line : PO BOX 373
Second Line :
City : TOPSHAM
State : ME
Zip : 04086-0373
Country : US
Telephone Number : 207-841-6649
Fax Number :
Provider Business Practice Location Address
First Line : 124 MAIN ST
Second Line :
City : TOPSHAM
State : ME
Zip : 04086-1221
Country : US
Telephone Number : 207-841-6649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 06/28/2012

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Directions to “ KERI ROTHERMEL LCSW” Practice Location

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