Provider Demographics
NPI:1699385591
Name:MARTIN, LUCY PAGE (LMSW-CC)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:PAGE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:
Other - Last Name:FUNKHOUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:375 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-3304
Mailing Address - Country:US
Mailing Address - Phone:207-975-2468
Mailing Address - Fax:
Practice Address - Street 1:375 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-3304
Practice Address - Country:US
Practice Address - Phone:207-975-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical