Provider Demographics
NPI:1336209394
Name:BESSEY, DEREK STEPHEN (LCSW)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:STEPHEN
Last Name:BESSEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ALAN ST
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1801
Mailing Address - Country:US
Mailing Address - Phone:207-798-0981
Mailing Address - Fax:
Practice Address - Street 1:63 ELM ST STE B
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1424
Practice Address - Country:US
Practice Address - Phone:207-725-7592
Practice Address - Fax:207-725-7593
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC54591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical