Provider Demographics
NPI:1225686629
Name:ABBOTT, ARIANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:
Last Name:ABBOTT
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 1:29 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9011
Mailing Address - Country:US
Mailing Address - Phone:203-313-9468
Mailing Address - Fax:
Practice Address - Street 1:535 OCEAN AVE STE 4
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-4970
Practice Address - Country:US
Practice Address - Phone:207-370-5389
Practice Address - Fax:207-510-8054
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC207281041C0700X
MEMC18171104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical