Individual
MILES PATRICK CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
37 ANDOVER RD, PORTLAND, ME 04102
(207) 661-3600
(207) 761-0783
Mailing address
37 ANDOVER RD, PORTLAND, ME 04102
(207) 661-3600
(207) 761-0783
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151-0125023
VT
1041C0700X
Clinical Social Worker
089-0111091
VT
1041C0700X
Clinical Social Worker
Primary
LC20435
ME
Other
Enumeration date
01/14/2016
Last updated
12/10/2021
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