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Individual

MR. FREEMAN R. COREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, LADC, CCS

Contact information

Practice address
7 HATCH DR, SUITE 240, CARIBOU, ME 04736-2159
(207) 498-2400
(207) 498-2400
Mailing address
899 RIVERSIDE ST, SUITE 240, PORTLAND, ME 04103-1070
(207) 871-1211
(207) 871-1232

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CCS3537
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC901
ME
1041C0700X
Clinical Social Worker
Primary
LC3744
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
098153
ANTHEM BCBS NUMBER
ME
05
431586399
ME
Enumeration date
12/04/2006
Last updated
02/02/2016
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