Provider Demographics
NPI:1093998536
Name:PHILPOTT, CECIL A (LMSWCC)
Entity Type:Individual
Prefix:MR
First Name:CECIL
Middle Name:A
Last Name:PHILPOTT
Suffix:
Gender:M
Credentials:LMSWCC
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 787
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605
Mailing Address - Country:US
Mailing Address - Phone:207-667-0909
Mailing Address - Fax:207-664-0147
Practice Address - Street 1:6 STILLWATER AVENUE
Practice Address - Street 2:UNIVERSITY MALL
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473
Practice Address - Country:US
Practice Address - Phone:207-827-4150
Practice Address - Fax:207-827-4180
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC9231104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker