Provider Demographics
NPI:1154442408
Name:POMROY, PATRICIA LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:POMROY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:LYNN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:145 LISBON ST
Mailing Address - Street 2:SUITE 305-308
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7235
Mailing Address - Country:US
Mailing Address - Phone:207-837-9517
Mailing Address - Fax:
Practice Address - Street 1:145 LISBON ST
Practice Address - Street 2:SUITE 305-308
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7235
Practice Address - Country:US
Practice Address - Phone:207-837-9517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC101751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432442099Medicaid