Individual
MR. DOUGLAS JAMES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
205 OCEAN AVE, PORTLAND, ME 04103-5712
(207) 773-7993
(207) 773-5512
Mailing address
9 COBBS BRIDGE RD, NEW GLOUCESTER, ME 04260-3834
(207) 926-4151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00974
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047305
ANTHEM
ME
Enumeration date
12/21/2006
Last updated
07/08/2007
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