Individual
KEVIN GARNER SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LADC
Contact information
Practice address
EASTPORT HEALTH CARE, 30 BOYNTON STREET, EASTPORT, ME 04631
(207) 853-0185
(207) 853-4248
Mailing address
PO BOX 630, CALAIS, ME 04619-0630
(207) 751-8712
(207) 454-0775
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC15430
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010276859
—
ME
Enumeration date
07/18/2013
Last updated
07/01/2019
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