Provider Demographics
NPI:1760490197
Name:ANDREWS, LOREN (LCSW)
Entity Type:Individual
Prefix:
First Name:LOREN
Middle Name:
Last Name:ANDREWS
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 1:8 TANNERY LN
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-1709
Mailing Address - Country:US
Mailing Address - Phone:207-236-7007
Mailing Address - Fax:207-236-7007
Practice Address - Street 1:8 TANNERY LN
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1709
Practice Address - Country:US
Practice Address - Phone:207-236-7007
Practice Address - Fax:207-236-7007
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC72621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME269280099Medicaid
MEMM8902Medicare ID - Type Unspecified