Individual
LAURA GOTTFRIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
178 MIDDLE ST, STE 300, PORTLAND, ME 04101-4075
(207) 773-0073
(207) 772-2670
Mailing address
343 FOREST AVE, PORTLAND, ME 04101-2006
(207) 874-1030
(207) 874-1044
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC5554
ME
1041C0700X
Clinical Social Worker
Primary
LC5554
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
316220099
—
ME
Enumeration date
08/31/2006
Last updated
02/17/2017
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