Individual
KIMBERLY A HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
175 WEST BROADWAY, LINCOLN, ME 04457-0000
(207) 794-6700
(207) 794-6777
Mailing address
PO BOX 99, LINCOLN, ME 04457-0099
(207) 794-6700
(207) 794-6777
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LC9962
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098304
ANTHEM LEGACY NUMBER
ME
05
—
161040200
—
ME
05
—
161040203
—
ME
05
—
161040204
—
ME
05
—
161040205
—
ME
05
—
161040206
—
ME
05
—
205890199
—
ME
Enumeration date
06/13/2006
Last updated
12/04/2013
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