Provider Demographics
NPI:1225663883
Name:STEPHANIE ROSE TRANCHEMONTAGNE, LCSW LLC
Entity Type:Organization
Organization Name:STEPHANIE ROSE TRANCHEMONTAGNE, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:TRANCHEMONTAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LLC
Authorized Official - Phone:207-502-5090
Mailing Address - Street 1:23 HALEY RD
Mailing Address - Street 2:
Mailing Address - City:ARUNDEL
Mailing Address - State:ME
Mailing Address - Zip Code:04046-7975
Mailing Address - Country:US
Mailing Address - Phone:207-502-5090
Mailing Address - Fax:
Practice Address - Street 1:95 INDIA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4250
Practice Address - Country:US
Practice Address - Phone:207-502-5090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty