Individual
ANDREW WELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
50 MOODY ST, SACO, ME 04072-1536
(800) 434-3400
Mailing address
PO BOX 397, BRUNSWICK, ME 04011-0397
(207) 522-1716
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC5395
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302190099
—
ME
Enumeration date
12/01/2006
Last updated
09/06/2019
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