Individual
NICHOLE E GULOWSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CADC, CCS
Contact information
Practice address
2821 MARIAVILLE RD, MARIAVILLE, ME 04605-7205
(207) 370-9397
(802) 332-3142
Mailing address
PO BOX 95, AURORA, ME 04408-0095
(207) 370-9397
(802) 332-3142
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC16682
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC5676
ME
101YM0800X
Mental Health Counselor
LC16682
ME
1041C0700X
Clinical Social Worker
Primary
LC16682
ME
Other
Enumeration date
02/05/2015
Last updated
03/03/2023
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