Provider Demographics
NPI:1639269947
Name:BLAND, BARBARA E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:E
Last Name:BLAND
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 1:29 ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:LAMOINE
Mailing Address - State:ME
Mailing Address - Zip Code:04605-4464
Mailing Address - Country:US
Mailing Address - Phone:207-667-1917
Mailing Address - Fax:207-667-1814
Practice Address - Street 1:198 MAIN ST
Practice Address - Street 2:SUITE 9
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1941
Practice Address - Country:US
Practice Address - Phone:207-667-1917
Practice Address - Fax:207-667-1917
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC76651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432331300Medicaid