Douglas Edmund Daggett, LMSW

Individual provider Active NPI School Social Worker · Freeport, ME

NPI 1780992008 · NPPES record last updated Sep 21, 2010

Key facts

NPI
1780992008
Entity type
Individual (NPI type 1)
Primary specialty
School Social Worker 1041S0200X
License
LM4188 (ME)
Practice address
30 Holbrook St
Freeport, ME 04032-1205
Phone
(207) 865-4706
NPI assigned
Sep 21, 2010
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LM4188MEMDSchool Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X LM4188 ME Yes

Addresses

Primary practice location

30 Holbrook St
Freeport, ME 04032-1205

Mailing address

30 Holbrook St
Freeport, ME 04032-1205
Phone (207) 865-4706

Other identifiers

IdentifierTypeStateIssuer
104150200XMedicaidME

Other providers in Freeport, ME

All providers in Freeport, ME · School Social Worker in Maine

Sources for this page

Verify at the official NPI Registry.