Individual
NANCY MAIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, LCSW
Contact information
Practice address
90 WHITNEY AVE, PORTLAND, ME 04102
(207) 752-0731
Mailing address
90 WHITNEY AVE, PORTLAND, ME 04102-5333
(207) 752-0731
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
653
NH
1041C0700X
Clinical Social Worker
Primary
LC16523
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042179
MMC
NH
01
—
1408079Y0NH02
BCBS
—
01
—
2042782
MCC BEHAVORIAL
—
01
—
MHS164441
VALUE OPTIONS HEALTHCARE
—
Enumeration date
05/02/2006
Last updated
10/04/2021
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