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Individual

MR. MARTIN FRANCIS BURGESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
26 SOUTH ST, BIDDEFORD, ME 04005-2447
(207) 283-8574
Mailing address
26 SOUTH ST, BIDDEFORD, ME 04005-2447
(207) 283-8574

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC1528
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040782
ANTHAM
01
11540310
CAQH
01
80089575
CCR TPIN
Enumeration date
11/14/2007
Last updated
08/22/2009
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