Provider Demographics
NPI:1437187564
Name:DAVIS, KRISTI SCHORS (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:SCHORS
Last Name:DAVIS
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 1:181 MARSHFIELD FLATS RD
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04654-5033
Mailing Address - Country:US
Mailing Address - Phone:207-255-8227
Mailing Address - Fax:
Practice Address - Street 1:43 TURNER WAY
Practice Address - Street 2:
Practice Address - City:CUTLER
Practice Address - State:ME
Practice Address - Zip Code:04626-3043
Practice Address - Country:US
Practice Address - Phone:207-255-8227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC114311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431940399Medicaid
ME431940399Medicaid