Individual
ELIZABETH BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CADC
Contact information
Practice address
1 HARNOIS AVE, WESTBROOK, ME 04092-4392
(207) 662-1340
(207) 662-1341
Mailing address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MC15240
ME
1041C0700X
Clinical Social Worker
Primary
LC16586
ME
Other
Enumeration date
03/16/2015
Last updated
10/11/2021
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