Organization
FREEDOM CHRISTIAN COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA CLARK LCSW, LADC, CCS (COUNSELOR)
(207) 882-5300
Entity
Organization
Contact information
Practice address
721 BATH RD, WISCASSET, ME 04578-4830
(207) 882-5300
Mailing address
721 BATH RD, WISCASSET, ME 04578-4830
(207) 882-5300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC3953
ME
1041C0700X
Clinical Social Worker
Primary
LC10536
ME
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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