Provider Demographics
NPI:1760441372
Name:MACOMBER, WILLIAM F JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:F
Last Name:MACOMBER
Suffix:JR
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 1:333 LINCOLN ST STE T1
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-3113
Mailing Address - Country:US
Mailing Address - Phone:207-571-8256
Mailing Address - Fax:
Practice Address - Street 1:333 LINCOLN ST STE T1
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3113
Practice Address - Country:US
Practice Address - Phone:207-571-8256
Practice Address - Fax:207-510-7674
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC78731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical