Provider Demographics
NPI:1073898599
Name:PILIBOSIAN, KATHE (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHE
Middle Name:
Last Name:PILIBOSIAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:NEW HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04554-0226
Mailing Address - Country:US
Mailing Address - Phone:207-482-0560
Mailing Address - Fax:
Practice Address - Street 1:15 BELVEDERE RD
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4644
Practice Address - Country:US
Practice Address - Phone:207-482-0560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC123771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical