MEDICARE: ANN ELIZABETH GAYER 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	LC3960	ME

General Provider Information

NPI Number	:	1669494969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN ELIZABETH GAYER LCSW

Provider Business Mailing Address
First Line	:	14 WOODROCK DR
Second Line	:
City	:	SCARBOROUGH
State	:	ME
Zip	:	04074
Country	:	US
Telephone Number	:	207-838-4850
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 OCEAN ST
Second Line	:	STE 201
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-3636
Country	:	US
Telephone Number	:	207-799-0060
Fax Number	:

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	01/07/2016

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