Provider Demographics
NPI:1265526115
Name:CORTESE, MARIA LEINA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LEINA
Last Name:CORTESE
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 1:62 PEGASUS ST. SUITE 200
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011
Mailing Address - Country:US
Mailing Address - Phone:207-373-0620
Mailing Address - Fax:207-373-0628
Practice Address - Street 1:62 PEGASUS ST. SUITE 200
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011
Practice Address - Country:US
Practice Address - Phone:207-373-0620
Practice Address - Fax:207-373-0628
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC74361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical