Organization
LIFE BY DESIGN, PA
Active
Organization
LIFE BY DESIGN, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH A GRAY LCSW, MHRT-C, CTCM (CHIEF EXECUTIVE OFFICER)
(207) 764-6825
Entity
Organization
Contact information
Practice address
147 ACADEMY ST, PRESQUE ISLE, ME 04769-3101
(207) 764-6825
(207) 764-6077
Mailing address
147 ACADEMY ST, PRESQUE ISLE, ME 04769-3101
(207) 764-6825
(207) 764-6077
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
429704
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163520000
—
ME
05
—
163520001
—
ME
05
—
163520100
—
ME
Enumeration date
07/10/2006
Last updated
06/20/2023
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