Provider Demographics
NPI:1871230250
Name:FOLLANSBEE, RACHAEL (LMSW-CC)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:FOLLANSBEE
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:OTISFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04270-6655
Mailing Address - Country:US
Mailing Address - Phone:207-890-7516
Mailing Address - Fax:
Practice Address - Street 1:1155 LISBON ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5025
Practice Address - Country:US
Practice Address - Phone:207-344-1841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC186991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1215979158Medicaid