Individual
VANESSA LYNN MACOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
66 STONE ST, AUGUSTA, ME 04330-5227
(207) 626-3455
Mailing address
67 EUSTIS PKWY, WATERVILLE, ME 04901-5173
(207) 660-4549
(207) 660-4529
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC21766
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649918426
—
ME
Enumeration date
05/23/2022
Last updated
12/07/2022
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