Provider Demographics
NPI:1679585384
Name:DEMERS, SYLVIE P (LCSW)
Entity Type:Individual
Prefix:
First Name:SYLVIE
Middle Name:P
Last Name:DEMERS
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 1:225 COMMERCIAL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-6606
Mailing Address - Country:US
Mailing Address - Phone:207-205-1935
Mailing Address - Fax:207-761-0265
Practice Address - Street 1:225 COMMERCIAL ST STE 300
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-6606
Practice Address - Country:US
Practice Address - Phone:207-205-1935
Practice Address - Fax:207-761-0265
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC98041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME281860099Medicaid
MEME1279Medicare PIN
ME281860099Medicaid