Individual
SHANE SULLIVAN SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
230 BARTLETT ST, LEWISTON, ME 04240-6578
(207) 783-4695
Mailing address
164 INTERVALE RD, NEW GLOUCESTER, ME 04260-3812
(207) 807-5610
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC8693
ME
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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