Provider Demographics
NPI:1982008520
Name:POWERS-CANDELMO, JULIEN MARIO (LCSW, CCS)
Entity Type:Individual
Prefix:
First Name:JULIEN
Middle Name:MARIO
Last Name:POWERS-CANDELMO
Suffix:
Gender:M
Credentials:LCSW, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 MAIN ST STE 201B
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5448
Mailing Address - Country:US
Mailing Address - Phone:207-536-4931
Mailing Address - Fax:207-221-1679
Practice Address - Street 1:650 MAIN ST STE 201B
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-5448
Practice Address - Country:US
Practice Address - Phone:207-536-4931
Practice Address - Fax:207-221-1679
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC118391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical