Individual
REBECCA A. BECKWITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
175 UNION ST STE C, BANGOR, ME 04401-6100
(207) 356-7992
Mailing address
175 UNION ST STE C, BANGOR, ME 04401-6100
(207) 356-7992
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC4168
ME
1041C0700X
Clinical Social Worker
Primary
LC13056
ME
1041C0700X
Clinical Social Worker
MC11198
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25564099
MAINE CARE
ME
Enumeration date
07/12/2007
Last updated
11/25/2019
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