Individual
MICHAEL B. IVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
110 MAIN ST STE 1508, SACO, ME 04072-3517
(207) 807-9110
(207) 560-9860
Mailing address
50 PINE COUNTRY DR, BUXTON, ME 04093-6447
(207) 807-9110
(207) 560-9860
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC16866
ME
Other
Enumeration date
09/28/2015
Last updated
04/28/2022
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