Provider Demographics
NPI:1184995599
Name:STURTEVANT, ADRIANNE (LICSW)
Entity type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:
Last Name:STURTEVANT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 FOREST AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-2009
Mailing Address - Country:US
Mailing Address - Phone:207-310-3724
Mailing Address - Fax:
Practice Address - Street 1:31707 NE 114TH ST
Practice Address - Street 2:
Practice Address - City:CARNATION
Practice Address - State:WA
Practice Address - Zip Code:98014-9700
Practice Address - Country:US
Practice Address - Phone:414-232-3716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW608073111041C0700X
NH20741041C0700X
MA1191301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical