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Organization

BONNIE I HANDY LCSW LADC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BONNIE IRENE HANDY LCSW, LADC (OWNER)
(207) 653-1371
Entity
Organization

Contact information

Practice address
57 TANDBERG TRL, SUITE #6, WINDHAM, ME 04062-6425
(207) 653-1371
Mailing address
PO BOX 160, GRAY, ME 04039-0160
(207) 653-1371

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC3393
ME
1041C0700X
Clinical Social Worker
Primary
LC6646
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME1202
MEDICARE ID
ME
Enumeration date
10/03/2012
Last updated
10/09/2013
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