Individual
ANDREA POMAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1329 BROADWAY, SOUTH PORTLAND, ME 04106-4110
(207) 799-4160
Mailing address
1329 BROADWAY, SOUTH PORTLAND, ME 04106-4110
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LC13032
ME
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
119801
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03021982
BEHAVIORAL HEALTH
—
01
—
1962786970
NON BILLING PROVIDER
—
Enumeration date
10/10/2011
Last updated
02/21/2021
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