Individual
COLIN ROUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
399 WATER ST STE 3, AUGUSTA, ME 04330-4691
(207) 805-4424
Mailing address
399 WATER ST STE 3, AUGUSTA, ME 04330-4691
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MC15799
ME
1041C0700X
Clinical Social Worker
LC16924
ME
251S00000X
Community/Behavioral Health Agency
Primary
LC16924
ME
Other
Enumeration date
01/18/2016
Last updated
05/30/2024
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