Organization
THEPLEASANTOAK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN A BROCHU LCSW (LICENSED CLINICAL SOCIAL WORKER)
(207) 441-6624
Entity
Organization
Contact information
Practice address
11 PARKWOOD DR, AUGUSTA, ME 04330-6252
(207) 441-6624
Mailing address
11 PARKWOOD DR, AUGUSTA, ME 04330-6252
(207) 441-6624
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC7597
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME1038
ME1038 PCAN
ME
Enumeration date
01/28/2015
Last updated
10/09/2024
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