Polly Margaret Colvin, LCSW

Individual provider Active NPI Clinical Social Worker · Ocean Park, ME

NPI 1417468331 · NPPES record last updated Apr 27, 2020

Key facts

NPI
1417468331
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LC7544 (ME)
Practice address
61 Colby Avenue
Ocean Park, ME 04063
Phone
(207) 934-5450
NPI assigned
Oct 18, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LC7544MEMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC7544 ME Yes

Addresses

Primary practice location

61 Colby Avenue
Ocean Park, ME 04063

Mailing address

PO Box 7385
Ocean Park, ME 04063-7385
Phone (207) 934-5450

Other providers in Ocean Park, ME

All providers in Ocean Park, ME · Clinical Social Worker in Maine

Sources for this page

Verify at the official NPI Registry.