Provider Demographics
NPI:1235204348
Name:MILLIKEN, CATHERINE LYNN (LCSW, LADC, CCS)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:LYNN
Last Name:MILLIKEN
Suffix:
Gender:F
Credentials:LCSW, LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 SAINT JOHN ST STE 114
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3054
Mailing Address - Country:US
Mailing Address - Phone:207-233-4654
Mailing Address - Fax:
Practice Address - Street 1:222 SAINT JOHN ST STE 114
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3054
Practice Address - Country:US
Practice Address - Phone:207-233-4654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECCS3670101Y00000X
MELC81231041C0700X
LC3437101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical