MEDICARE: ANDREW A PHINNEY 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
1	1041C0700X	Clinical Social Worker	LC18626	ME

General Provider Information

NPI Number	:	1427556331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW A PHINNEY LCSW

Provider Business Mailing Address
First Line	:	250 CENTER STREET
Second Line	:	STE 6 #1018
City	:	AUBURN
State	:	ME
Zip	:	04210-6152
Country	:	US
Telephone Number	:	207-370-9585
Fax Number	:

Provider Business Practice Location Address
First Line	:	293 BLUE RD
Second Line	:
City	:	MONMOUTH
State	:	ME
Zip	:	04259-6900
Country	:	US
Telephone Number	:	207-370-9585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2018
Last Update Date	:	01/23/2025

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