Individual
MRS. ELIZABETH ALICE KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LADC, CCS
Contact information
Practice address
235 MAIN ST, BIDDEFORD, ME 04005-2411
(207) 468-0255
Mailing address
235 MAIN ST, BIDDEFORD, ME 04005-2411
(207) 468-0255
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC7033
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC7290
ME
1041C0700X
Clinical Social Worker
Primary
LC19976
ME
1041C0700X
Clinical Social Worker
MC17660
ME
Other
Enumeration date
05/19/2020
Last updated
08/29/2022
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