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NPI Code Detail

MEDICARE: SPENCER MELNICK L.C.S.W.

MEDICARE: SPENCER MELNICK L.C.S.W.
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 WorkerME236254ME

General Provider Information

NPI Number : 1992882161
Entity Type Code : Individual
Provider Name (Legal Business Name) : SPENCER MELNICK L.C.S.W.
Provider Business Mailing Address
First Line : 17 SOUTH ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3914
Country : US
Telephone Number : 207-299-3172
Fax Number :
Provider Business Practice Location Address
First Line : 17 SOUTH ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3914
Country : US
Telephone Number : 207-299-3172
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ SPENCER MELNICK L.C.S.W.” Practice Location

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