Individual
ANDREW PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
854 BROADWAY, SOUTH PORTLAND, ME 04106-2712
(207) 776-8146
(207) 799-2303
Mailing address
117 OSBORNE AVE, SOUTH PORTLAND, ME 04106-4447
(207) 776-8146
(207) 779-2303
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC9966
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431883099
—
ME
Enumeration date
03/02/2007
Last updated
07/10/2007
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