Individual
PHILLIP W REPPOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
38 PLYMOUTH DR, SACO, ME 04072-1734
(207) 282-4920
(707) 598-1038
Mailing address
38 PLYMOUTH DR, SACO, ME 04072-1734
(207) 282-4920
(707) 598-1038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCS925
ME
1041C0700X
Clinical Social Worker
Primary
LCS925
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432427399
—
ME
Enumeration date
06/23/2008
Last updated
09/03/2010
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