Provider Demographics
NPI:1851758874
Name:TALON, KATIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:
Last Name:TALON
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:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:NORTH MONMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04265-0092
Mailing Address - Country:US
Mailing Address - Phone:207-215-4782
Mailing Address - Fax:
Practice Address - Street 1:50 LYDIA LN
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2156
Practice Address - Country:US
Practice Address - Phone:207-215-4782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC138871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical