Individual
ALLISON BASILE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
153 PARK ROW, BRUNSWICK, ME 04011-2053
(207) 725-0400
Mailing address
30 EASTERN SHORE RD, BRUNSWICK, ME 04011-8128
(207) 729-7585
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC154
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003807
ANTHEM PROVIDER NUMBER
ME
Enumeration date
06/16/2006
Last updated
07/08/2007
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