Individual
CHRISTOPHER MCINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1012 UNION ST, PENOBSCOT COMMUNITY HEALTH CENTER, BANGOR, ME 04401-3060
(207) 404-8100
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11536
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161040200
—
ME
05
—
161040203
—
ME
05
—
434137099
—
ME
Enumeration date
10/03/2006
Last updated
04/19/2016
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