Provider Demographics
NPI:1831310010
Name:TRUE, TIMOTHY G (LCSW)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:G
Last Name:TRUE
Suffix:
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 1:740 STROUDWATER ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-4059
Mailing Address - Country:US
Mailing Address - Phone:207-591-5011
Mailing Address - Fax:888-341-5592
Practice Address - Street 1:740 STROUDWATER ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4059
Practice Address - Country:US
Practice Address - Phone:207-591-5011
Practice Address - Fax:888-341-5592
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC57461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical