Individual
GEORGETTE A BEAULIEU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
421 MAIN ST, PRESQUE ISLE, ME 04769-2660
(207) 764-8573
Mailing address
PO BOX 1820, PRESQUE ISLE, ME 04769-1820
(207) 764-7529
(207) 764-6504
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC1512
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5588
ANTHEM PROVIDER ID
ME
Enumeration date
12/01/2006
Last updated
07/08/2007
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