Individual
ILSE WENTWORTH LARRIVEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
30 CHESTNUT ST # 25, CAMDEN, ME 04843-2210
(207) 631-9235
Mailing address
27 PEACEDALE DR, NORTHPORT, ME 04849-3252
(207) 930-5992
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC13719
ME
1041C0700X
Clinical Social Worker
Primary
MC12594
ME
Other
Enumeration date
08/04/2010
Last updated
05/12/2026
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