Provider Demographics
NPI:1356442016
Name:GUERIN, CINDY M (LCSW)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:M
Last Name:GUERIN
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 1:11 MULLIKEN CT
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7242
Mailing Address - Country:US
Mailing Address - Phone:207-622-1552
Mailing Address - Fax:207-621-8376
Practice Address - Street 1:11 MULLIKEN CT
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-7242
Practice Address - Country:US
Practice Address - Phone:207-622-1552
Practice Address - Fax:207-621-8376
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC99231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEME1615Medicare ID - Type Unspecified