Individual
ELIZABETH JANE MACINNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-CC, CADC
Contact information
Practice address
71 US ROUTE 1 STE E, SCARBOROUGH, ME 04074-7168
(207) 773-9931
Mailing address
27 FAIRWAY DR, SCARBOROUGH, ME 04074
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CAC6490
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326030701
—
ME
Enumeration date
11/22/2017
Last updated
01/03/2020
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