Individual
SUSAN HASKELL CORREIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
380 WESTERN AVE STE D, SOUTH PORTLAND, ME 04106-1720
(207) 775-1670
Mailing address
PO BOX 1024, PORTLAND, ME 04104-1024
(207) 775-1670
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4335
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016910
ANTHEM BLUE CROSS BLUE SH
ME
01
—
227305000
MAGELLAN
ME
01
—
5511272
AETNA
ME
Enumeration date
03/02/2007
Last updated
02/18/2020
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