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Contact Information

MARY L FREDRICKS, LCSW
38 UNION ST
LIVERMORE FALLS, ME04254
 Phone: 207-897-6601
 Fax: 207-897-4339
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for MARY L FREDRICKS · (Female)

NPI # 1376510412
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 03/08/2006
Last updated 11/15/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • ME License # ME129365
  • ME Medicaid 218840099
  • ME Other 047005 ANTHEM
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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