Individual
MICA T. SLAVEN-LAMOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MHRT-CSP
Contact information
Practice address
710 BUCKSPORT RD, ELLSWORTH, ME 04605-2722
(207) 667-6890
(207) 687-6457
Mailing address
710 BUCKSPORT RD, ELLSWORTH, ME 04605-2722
(207) 667-6890
(207) 687-6457
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
LC14722
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103850000
—
ME
Enumeration date
02/23/2012
Last updated
08/20/2014
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