Individual
KATHERINE M DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
43 COLUMBIA ST, SUITE 11, BANGOR, ME 04401-6346
(207) 941-8829
(207) 825-3827
Mailing address
43 COLUMBIA ST, SUITE 11, BANGOR, ME 04401-6346
(207) 941-8829
(207) 825-3827
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC3871
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037459
ANTHEM BLUE CROSS
ME
01
—
11255707
CAQH
ME
01
—
7675142
AETNA
ME
Enumeration date
06/03/2006
Last updated
07/08/2007
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