MEDICARE: KAREN A TOOTHAKER 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	LC22580	ME

General Provider Information

NPI Number	:	1447867957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN A TOOTHAKER LCSW

Provider Business Mailing Address
First Line	:	78 OLD COUNTY RD
Second Line	:
City	:	STOCKTON SPRINGS
State	:	ME
Zip	:	04981-4014
Country	:	US
Telephone Number	:	207-768-0622
Fax Number	:

Provider Business Practice Location Address
First Line	:	78 OLD COUNTY RD
Second Line	:
City	:	STOCKTON SPRINGS
State	:	ME
Zip	:	04981-4014
Country	:	US
Telephone Number	:	207-768-0622
Fax Number	:

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

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	03/19/2026

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