Provider Demographics
NPI:1457613317
Name:LINEN, CAMERON SCRANTON (LPASTC-C)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:SCRANTON
Last Name:LINEN
Suffix:
Gender:M
Credentials:LPASTC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WISTERIA CIR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1443
Mailing Address - Country:US
Mailing Address - Phone:207-776-2627
Mailing Address - Fax:
Practice Address - Street 1:9 WISTERIA CIR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1443
Practice Address - Country:US
Practice Address - Phone:207-776-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXP3926101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral