| Charlie Charlton, Licsw, Llc | |
|
18 Lovers Ln Cushing ME 04563-3255 | |
| (207) 975-2349 | |
| (207) 975-2349 |
| Full Name | Charlie Charlton, Licsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 18 Lovers Ln, Cushing, Maine |
| Authorized Official Name and Position | Ursula Charlie Charlton (OWNER AND PROVIDER) |
| Authorized Official Contact | 2079752349 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charlie Charlton, Licsw, Llc 18 Lovers Ln Cushing ME 04563-3255 Ph: (207) 975-2349 | Charlie Charlton, Licsw, Llc 18 Lovers Ln Cushing ME 04563-3255 Ph: (207) 975-2349 |
| NPI Number | 1174230643 |
|---|---|
| Provider Enumeration Date | 11/03/2022 |
| Last Update Date | 09/15/2024 |
| Certification Date | 09/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174230643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |