Individual
DR. SAMANTHA MARISTANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LADC CCS LICSW
Contact information
Practice address
725 MAIN ST, SOUTH PORTLAND, ME 04106-5424
(207) 331-4371
Mailing address
725 MAIN ST, SOUTH PORTLAND, ME 04106-5424
(207) 331-4371
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CCS8543
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC8009
ME
1041C0700X
Clinical Social Worker
Primary
LC21139
ME
1041C0700X
Clinical Social Worker
LICSW126257
MA
Other
Enumeration date
10/26/2020
Last updated
11/16/2023
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