Organization
JULIE ANN PETERSON, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE ANN PETERSON LCSW (PRESIDENT)
(207) 739-2454
Entity
Organization
Contact information
Practice address
28 WINTER ST, UNIT 2, NORWAY, ME 04268-5620
(207) 890-8779
(207) 739-2453
Mailing address
PO BOX 633, NORWAY, ME 04268-0633
(207) 890-8779
(207) 739-2453
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC8164
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11328070
CAQH PROVIDER NUMBER
ME
05
—
27611000099
—
ME
Enumeration date
09/26/2006
Last updated
08/22/2020
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