Individual
MR. SIMON MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
68 CARIBOU ST, PORTLAND, ME 04102-2402
(207) 409-2620
Mailing address
68 CARIBOU ST, PORTLAND, ME 04102-2402
(207) 409-2620
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC16798
ME
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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