Therese Johnson
Individual provider Active NPI Clinical Social Worker · Bridgton, ME
NPI 1881925360 · NPPES record last updated Jan 22, 2010
Key facts
- NPI
- 1881925360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- MC11705 (ME)
- Practice address
- 32 N High St
Bridgton, ME 04009-1125 - Phone
- (207) 647-5629
- NPI assigned
- Jan 22, 2010
- Sex
- Female
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| MC11705 | ME | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MC11705 | ME | Yes |
Addresses
Primary practice location
32 N High St
Bridgton, ME 04009-1125
Mailing address
1155 Lisbon St
Lewiston, ME 04240-5025
Phone (207) 783-9141
Other providers in Bridgton, ME
- Andrea Jahna
- Jodi Marie Janda
- Jed D Jankowski
- Florence Frances Jello
- Andrea M Johnson
- Robert Jones
- Joyful Balance Holistic Healing PLLC
- K.Taylor Zimmel Counseling
- Catherine J Kasprak
- Deborah Ellen Kauffman
All providers in Bridgton, ME · Clinical Social Worker in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.