Provider Demographics
NPI:1427556331
Name:PHINNEY, ANDREW A (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:A
Last Name:PHINNEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 CENTER STREET
Mailing Address - Street 2:STE 6 #1018
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6152
Mailing Address - Country:US
Mailing Address - Phone:207-370-9585
Mailing Address - Fax:
Practice Address - Street 1:293 BLUE RD
Practice Address - Street 2:
Practice Address - City:MONMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04259-6900
Practice Address - Country:US
Practice Address - Phone:207-370-9585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC186261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical