Provider Demographics
NPI:1255689832
Name:KATHLEEN ST. JAMES, LCSW
Entity Type:Organization
Organization Name:KATHLEEN ST. JAMES, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STJAMES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-504-1060
Mailing Address - Street 1:301 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1556
Mailing Address - Country:US
Mailing Address - Phone:207-504-1060
Mailing Address - Fax:866-904-9845
Practice Address - Street 1:301 MAIN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1556
Practice Address - Country:US
Practice Address - Phone:207-504-1060
Practice Address - Fax:866-904-9845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC52961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty