Provider Demographics
NPI:1700253614
Name:ESTY, ERIC STEPHEN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:STEPHEN
Last Name:ESTY
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 1:35 WESTMINSTER ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-3531
Mailing Address - Country:US
Mailing Address - Phone:207-783-0068
Mailing Address - Fax:
Practice Address - Street 1:35 WESTMINSTER ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-3531
Practice Address - Country:US
Practice Address - Phone:207-783-0068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC152001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical