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Individual

ERVIN W LORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
60 FRONT ST, WATERVILLE, ME 04901-6658
(207) 649-1098
Mailing address
PO BOX 6400, CHINA VILLAGE, ME 04926-0400
(207) 649-1098

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LC6939
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
431642699
ME
05
431823900
ME
Enumeration date
07/20/2006
Last updated
07/06/2009
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