Provider Demographics
NPI:1134329014
Name:RAND, BOBBIE-JO (LCSW, LADC)
Entity type:Individual
Prefix:
First Name:BOBBIE-JO
Middle Name:
Last Name:RAND
Suffix:
Gender:F
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CRAWFORD RD
Mailing Address - Street 2:
Mailing Address - City:WEST BALDWIN
Mailing Address - State:ME
Mailing Address - Zip Code:04091-3030
Mailing Address - Country:US
Mailing Address - Phone:207-831-4204
Mailing Address - Fax:
Practice Address - Street 1:29 CRAWFORD RD
Practice Address - Street 2:
Practice Address - City:WEST BALDWIN
Practice Address - State:ME
Practice Address - Zip Code:04091-3030
Practice Address - Country:US
Practice Address - Phone:207-831-4204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC131041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical