| Laurie Sivonen Lcsw Llc | |
|
4 Scammon St Ste 19-399 Saco ME 04072-5121 | |
| (207) 221-6644 | |
| (207) 510-8021 |
| Full Name | Laurie Sivonen Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4 Scammon St Ste 19-399, Saco, Maine |
| Authorized Official Name and Position | Laurie Sivonen (OWNER) |
| Authorized Official Contact | 2072216644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laurie Sivonen Lcsw Llc 6 Sokokis Cir Saco ME 04072-1874 Ph: (207) 221-6644 | Laurie Sivonen Lcsw Llc 4 Scammon St Ste 19-399 Saco ME 04072-5121 Ph: (207) 221-6644 |
| NPI Number | 1952855629 |
|---|---|
| Provider Enumeration Date | 08/10/2016 |
| Last Update Date | 05/18/2022 |
| Certification Date | 05/18/2022 |
| Medicare PECOS PAC ID | 1951708791 |
|---|---|
| Medicare Enrollment ID | O20210922000495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952855629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC11993 (Maine) | Primary |
| Provider Name | Laurie J Sivonen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053567867 PECOS PAC ID: 2466731906 Enrollment ID: I20161128000892 |
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