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Individual

LAWRENCE JOEL HERDADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
195 NORTH ST, PORTLAND, ME 04101-2734
(207) 874-8228
(207) 874-8234
Mailing address
195 NORTH ST, PORTLAND, ME 04101-2734
(207) 874-8228
(207) 874-8234

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LC1169
ME
1041S0200X
School Social Worker
Primary
LC1169
ME

Other

Enumeration date
02/28/2011
Last updated
02/28/2011
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